<SEC-DOCUMENT>0001193125-18-045748.txt : 20180214
<SEC-HEADER>0001193125-18-045748.hdr.sgml : 20180214
<ACCEPTANCE-DATETIME>20180214165430
ACCESSION NUMBER:		0001193125-18-045748
CONFORMED SUBMISSION TYPE:	10-K
PUBLIC DOCUMENT COUNT:		98
CONFORMED PERIOD OF REPORT:	20171231
FILED AS OF DATE:		20180214
DATE AS OF CHANGE:		20180214

FILER:

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			MEDNAX, INC.
		CENTRAL INDEX KEY:			0000893949
		STANDARD INDUSTRIAL CLASSIFICATION:	SERVICES-HOSPITALS [8060]
		IRS NUMBER:				263667538
		STATE OF INCORPORATION:			FL
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		10-K
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-12111
		FILM NUMBER:		18613099

	BUSINESS ADDRESS:	
		STREET 1:		1301 CONCORD TERRACE
		CITY:			SUNRISE
		STATE:			FL
		ZIP:			33323
		BUSINESS PHONE:		9543840175

	MAIL ADDRESS:	
		STREET 1:		1301 CONCORD TERRACE
		CITY:			SUNRISE
		STATE:			FL
		ZIP:			33323

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	PEDIATRIX MEDICAL GROUP INC
		DATE OF NAME CHANGE:	19950801
</SEC-HEADER>
<DOCUMENT>
<TYPE>10-K
<SEQUENCE>1
<FILENAME>d463027d10k.htm
<DESCRIPTION>FORM 10-K
<TEXT>
<HTML><HEAD>
<TITLE>Form 10-K</TITLE>
</HEAD>
 <BODY BGCOLOR="WHITE">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="line-height:0px;margin-top:0px;margin-bottom:0px;border-bottom:0.5pt solid #000000">&nbsp;</P>
<P STYLE="line-height:3px;margin-top:0px;margin-bottom:2px;border-bottom:0.5pt solid #000000">&nbsp;</P> <P STYLE="margin-top:3px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="5"><B>UNITED STATES </B></FONT></P>
<P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="5"><B>SECURITIES AND EXCHANGE COMMISSION </B></FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="3"><B>Washington, D.C. 20549 </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="5"><B>Form <FONT STYLE="white-space:nowrap">10-K</FONT>
</B></FONT></P> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="3"><B></B>&#9746;<B></B><B></B></FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="3"><B>ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 </B></FONT></TD></TR></TABLE>
<P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="3"><B>For the fiscal year ended December&nbsp;31, 2017 </B></FONT></P> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="3"><B></B>&#9744;<B></B><B></B></FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="3"><B>TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 </B></FONT></TD></TR></TABLE>
<P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="3"><B>For the transition period from
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;to&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="3"><B>Commission file number <FONT STYLE="white-space:nowrap">001-12111</FONT> </B></FONT></P>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P><center> <P STYLE="line-height:6px;margin-top:0px;margin-bottom:2px;border-bottom:1pt solid #000000;width:21%">&nbsp;</P></center>
<P STYLE="margin-top:6px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="6"><B>MEDNAX, INC. </B></FONT></P>
<P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>(Exact name of registrant as specified in its charter) </B></FONT></P>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="49%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD WIDTH="47%"></TD></TR>


<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>FLORIDA</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="top" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><FONT STYLE="white-space:nowrap">26-3667538</FONT></B></FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>(State or other jurisdiction<BR>of incorporation or organization)</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="top" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>(I.R.S. Employer<BR>Identification No.)</B></FONT></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>1301 Concord Terrace, Sunrise, Florida</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="top" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>33323</B></FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>(Address of principal executive offices)</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="top" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>(Zip Code)</B></FONT></TD></TR>
</TABLE> <P STYLE="margin-top:6px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Registrant&#146;s telephone number, including area code (954)
<FONT STYLE="white-space:nowrap">384-0175</FONT> </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Securities registered pursuant to Section&nbsp;12(b) of the Act:
</B></FONT></P> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="49%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD WIDTH="47%"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom" ALIGN="center"> <P STYLE="border-bottom:1px solid #000000;width:64pt ; display:inline;" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Title of Each Class</B></FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="center"> <P STYLE="border-bottom:1px solid #000000;width:156pt ; display:inline;" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Name of Each Exchange on Which Registered</B></FONT></P></TD></TR>


<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Common Stock, par value $.01 per share</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="top" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>New York Stock Exchange</B></FONT></TD></TR>
</TABLE> <P STYLE="margin-top:6px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Securities registered pursuant to Section&nbsp;12(g) of the Act: None </B></FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:3%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities
Act.&nbsp;&nbsp;&nbsp;&nbsp;Yes&nbsp;&nbsp;&#9746;&nbsp;&nbsp;&nbsp;&nbsp;No&nbsp;&nbsp;&#9744; </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:3%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Indicate by check mark if the
registrant is not required to file reports pursuant to Section&nbsp;13 or Section&nbsp;15 (d) of the Exchange Act.&nbsp;&nbsp;&nbsp;&nbsp;Yes&nbsp;&nbsp;&#9744;&nbsp;&nbsp;&nbsp;&nbsp;No&nbsp;&nbsp;&#9746; </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:3%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Indicate by check mark whether the registrant (1)&nbsp;has filed all reports required to be filed by Section&nbsp;13 or 15(d) of the
Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2)&nbsp;has been subject to such filing requirements for the past 90
days.&nbsp;&nbsp;&nbsp;&nbsp;Yes&nbsp;&nbsp;&#9746;&nbsp;&nbsp;&nbsp;&nbsp;No&nbsp;&nbsp;&#9744; </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:3%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Indicate by check mark
whether the registrant has submitted electronically and posted on its Corporate Website, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation <FONT STYLE="white-space:nowrap">S-T</FONT>
(&#167;232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).&nbsp;&nbsp;&nbsp;&nbsp;Yes&nbsp;&nbsp;&#9746;&nbsp;&nbsp;&nbsp;&nbsp;No&nbsp;&nbsp;&#9744;
</FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:3%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation
<FONT STYLE="white-space:nowrap">S-K</FONT> (&#167;229.405 of this chapter) is not contained herein, and will not be contained, to the best of registrant&#146;s knowledge, in definitive proxy or information statements incorporated by reference in
Part III of this Form <FONT STYLE="white-space:nowrap">10-K</FONT> or any amendment to this Form <FONT STYLE="white-space:nowrap">10-K.&nbsp;&nbsp;&#9744;</FONT> </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:3%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a <FONT STYLE="white-space:nowrap">non-accelerated</FONT> filer, a smaller reporting company, or an
emerging growth company. See the definitions of &#147;large accelerated filer,&#148; &#147;accelerated filer,&#148; &#147;smaller reporting company,&#148; and &#147;emerging growth company&#148; in Rule <FONT STYLE="white-space:nowrap">12b-2</FONT>
of the Exchange Act. </FONT></P> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="92%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="27%"></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD WIDTH="17%"></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD WIDTH="21%"></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD WIDTH="26%"></TD></TR>


<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">Large accelerated filer&nbsp;&nbsp;&#9746;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Accelerated&nbsp;filer&nbsp;&nbsp;&#9744;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Non-accelerated&nbsp;filer&nbsp;&nbsp;&#9744;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Smaller&nbsp;reporting&nbsp;company&nbsp;&nbsp;&#9744;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Emerging growth company&nbsp;&nbsp;&#9744;</FONT></TD></TR>
</TABLE> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:3%"><FONT STYLE="font-family:Times New Roman" SIZE="2">If an emerging growth company, indicate by check mark if the registrant has elected not to use the
extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section&nbsp;13(a) of the Exchange Act.&nbsp;&nbsp;&#9744; </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:3%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Indicate by check mark whether the registrant is a shell company (as defined by Rule <FONT STYLE="white-space:nowrap">12b-2</FONT> of the Exchange
Act).&nbsp;&nbsp;&nbsp;&nbsp;Yes&nbsp;&nbsp;&#9744;&nbsp;&nbsp;&nbsp;&nbsp;No&nbsp;&nbsp;&#9746; </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:3%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The aggregate market value of
shares of Common Stock of the registrant held by <FONT STYLE="white-space:nowrap">non-affiliates</FONT> of the registrant on June&nbsp;30, 2017, the last business day of the registrant&#146;s most recently completed second fiscal quarter, was
$4,785,069,881 based on a $60.37 closing price per share as reported on the New York Stock Exchange composite transactions list on such date. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:3%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The number of shares of Common Stock of the registrant outstanding on February&nbsp;9, 2018 was 93,795,535. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>DOCUMENTS INCORPORATED BY REFERENCE: </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:3%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The registrant&#146;s definitive
proxy statement to be filed with the Securities and Exchange Commission pursuant to Regulation 14A, with respect to the 2018 Annual Meeting of Shareholders is incorporated by reference in Part III of this Form
<FONT STYLE="white-space:nowrap">10-K</FONT> to the extent stated herein. Except with respect to information specifically incorporated by reference in the Form <FONT STYLE="white-space:nowrap">10-K,</FONT> each document incorporated by reference
herein is deemed not to be filed as part hereof. </FONT></P> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P> <P STYLE="line-height:0px;margin-top:0px;margin-bottom:0px;border-bottom:0.5pt solid #000000">&nbsp;</P>
<P STYLE="line-height:3px;margin-top:0px;margin-bottom:2px;border-bottom:0.5pt solid #000000">&nbsp;</P>

<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ANNUAL REPORT ON FORM <FONT STYLE="white-space:nowrap">10-K</FONT> </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>For the Year Ended December&nbsp;31, 2017 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="toc"></A>INDEX </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="9%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="78%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><B><A HREF="#tx463027_30">PART I</A></B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 1.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx463027_1">Business</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;1A.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx463027_2">Risk Factors</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">28</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 1B.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx463027_3">Unresolved Staff Comments</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">43</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 2.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx463027_4">Properties</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">43</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 3.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx463027_5">Legal Proceedings</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">43</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 4.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx463027_6">Mine Safety Disclosures</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">43</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><B><A HREF="#tx463027_31">PART&nbsp;II</A></B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 5.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_7">Market for Registrant&#146;s Common Equity, Related Stockholder Matters and
 Issuer Purchases of Equity Securities</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">44</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 6.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_8">Selected Financial Data</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">47</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 7.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_9">Management&#146;s Discussion and Analysis of Financial Condition and Results
 of Operations</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">48</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 7A.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_10">Quantitative and Qualitative Disclosures About Market Risk</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">63</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 8.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_11">Financial Statements and Supplementary Data</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">64</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 9.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_12">Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">94</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 9A.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_13">Controls and Procedures</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">94</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 9B.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_13a">Other Information </A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">95</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><B><A HREF="#tx463027_32">PART&nbsp;III</A></B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 10.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx463027_14">Directors, Executive Officers and Corporate Governance</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">96</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 11.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx463027_15">Executive Compensation</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">96</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 12.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_16">Security Ownership of Certain Beneficial Owners and Management and Related
 Stockholder Matters</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">96</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 13.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx463027_17">Certain Relationships and Related Transactions, and Director Independence</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">96</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 14.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx463027_18">Principal Accounting Fees and Services</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">97</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><B><A HREF="#tx463027_33">PART&nbsp;IV</A></B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 15.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx463027_19">Exhibits, Financial Statement Schedule</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">98</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item 16.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx463027_20">Form 10-K Summary</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">101</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FORWARD-LOOKING STATEMENTS </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Certain information included or incorporated by reference in this Form <FONT STYLE="white-space:nowrap">10-K</FONT> may be deemed to be
&#147;forward-looking statements&#148; which may include, but are not limited to, statements relating to our objectives, plans and strategies, and all statements (other than statements of historical facts) that address activities, events or
developments that we intend, expect, project, believe or anticipate will or may occur in the future. These statements are often characterized by terminology such as &#147;believe,&#148; &#147;hope,&#148; &#147;may,&#148; &#147;anticipate,&#148;
&#147;should,&#148; &#147;intend,&#148; &#147;plan,&#148; &#147;will,&#148; &#147;expect,&#148; &#147;estimate,&#148; &#147;project,&#148; &#147;positioned,&#148; &#147;strategy&#148; and similar expressions, and are based on assumptions and
assessments made by our management in light of their experience and their perception of historical trends, current conditions, expected future developments and other factors they believe to be appropriate. Any forward-looking statements in this Form
<FONT STYLE="white-space:nowrap">10-K</FONT> are made as of the date hereof, and we undertake no duty to update or revise any such statements, whether as a result of new information, future events or otherwise. Forward-looking statements are not
guarantees of future performance and are subject to risks and uncertainties. Important factors that could cause actual results, developments and business decisions to differ materially from forward-looking statements are described in this Form <FONT
STYLE="white-space:nowrap">10-K,</FONT> including the risks set forth under &#147;Risk Factors&#148; in Item 1A. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">2 </P>


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 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As used in this Form <FONT STYLE="white-space:nowrap">10-K,</FONT> unless the context otherwise
requires, the terms &#147;MEDNAX,&#148; the &#147;Company,&#148; &#147;we,&#148; &#147;us&#148; and &#147;our&#148; refer to the parent company, MEDNAX, Inc., a Florida corporation, and the consolidated subsidiaries through which its businesses are
actually conducted (collectively, &#147;MDX&#148;), together with MDX&#146;s affiliated business corporations or professional associations, professional corporations, limited liability companies and partnerships (&#147;affiliated professional
contractors&#148;). Certain subsidiaries of MDX have contracts with our affiliated professional contractors, which are separate legal entities that provide physician services in certain states and Puerto Rico. All share and per share data set forth
herein give effect to the <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">two-for-one</FONT></FONT> split of our common stock that became effective on December&nbsp;19, 2013. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx463027_30"></A>PART I </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="9%" VALIGN="top" ALIGN="left"><B><A NAME="tx463027_1"></A>ITEM&nbsp;1.</B></TD>
<TD ALIGN="left" VALIGN="top"><B>BUSINESS </B></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>OVERVIEW </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">MEDNAX is a leading provider of physician services including newborn, anesthesia, maternal-fetal, radiology and teleradiology, pediatric
cardiology and other pediatric subspecialty care. At December&nbsp;31, 2017, our national network comprised over 4,075 affiliated physicians, including 1,175 physicians who provide neonatal clinical care, primarily within hospital-based neonatal
intensive care units (&#147;NICUs&#148;), to babies born prematurely or with medical complications. We have 1,400 affiliated physicians who provide anesthesia care to patients in connection with surgical and other procedures, as well as pain
management. In addition, we have 325 affiliated physicians who provide maternal-fetal and obstetrical medical care to expectant mothers experiencing complicated pregnancies primarily in areas where our affiliated neonatal physicians practice. Our
network also includes other pediatric subspecialists, including 175 physicians providing pediatric intensive care, 110 physicians providing pediatric cardiology care, 130 physicians providing hospital-based pediatric care, 20 physicians providing
pediatric surgical care, and eight physicians providing pediatric ear, nose and throat and pediatric ophthalmology services. MEDNAX also provides radiology services including diagnostic imaging, interventional radiology and nuclear medicine, through
a network of 285 affiliated physicians, as well as teleradiology services through a network of 445 affiliated radiologists. In addition to our national physician network, we provide services to healthcare facilities and physicians, including ours,
through complementary businesses, consisting of a management services organization focusing on full-service revenue cycle management and a consulting services company. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">MEDNAX, Inc. was incorporated in Florida in 2007 and is the successor to Pediatrix Medical Group, Inc., which was incorporated in Florida in
1979. Our principal executive offices are located at 1301 Concord Terrace, Sunrise, Florida 33323 and our telephone number is (954) <FONT STYLE="white-space:nowrap">384-0175.</FONT> </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>OUR PHYSICIAN SPECIALTIES AND SERVICES </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following discussion describes our physician specialties and the care that we provide: </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Neonatal Care </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We provide clinical care
to babies born prematurely or with complications within specific units at hospitals, primarily NICUs, through our network of 1,175 affiliated neonatal physician subspecialists (&#147;neonatologists&#148;), neonatal nurse practitioners and other
pediatric clinicians who staff and manage clinical activities at more than 390 NICUs in 37 states and Puerto Rico. Neonatologists are board-certified, or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">eligible-to-apply-for-certification,</FONT></FONT></FONT></FONT> physicians who have extensive education and training for the care of babies born prematurely or with complications that
require complex medical treatment. Neonatal nurse practitioners are registered nurses who have advanced training and education in assessing and treating the healthcare needs of newborns and infants as well as managing the needs of their families.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We partner with our hospital clients in an effort to enhance the quality of care delivered to premature and sick babies. Some of the
nation&#146;s largest and most prestigious hospitals, including both <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">not-for-profit</FONT></FONT> and </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">3 </P>


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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
<FONT STYLE="white-space:nowrap">for-profit</FONT> institutions, retain us to staff and manage their NICUs. Our affiliated neonatologists generally provide <FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">24-hours-a-day,</FONT></FONT></FONT> <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">seven-days-a-week</FONT></FONT> coverage in NICUs, support the local referring
physician community and are available for consultation in other hospital departments. Our hospital partners benefit from our experience in managing complex intensive care units. Our neonatal physicians interact with colleagues across the country
through an internal communications system to draw upon their collective expertise in managing challenging patient-care issues. Our neonatal physicians also work collaboratively with maternal-fetal medicine subspecialists to coordinate the care of
mothers experiencing complicated pregnancies and their fetuses. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Anesthesia and Anesthesia Subspecialty Care </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We provide anesthesia care at over 155 hospitals, 160 ambulatory surgery centers and office-based practices across 15 states with 1,400
affiliated anesthesiologists. Following the &#147;care team&#148; model, our anesthesiologists work with both practice and hospital-employed certified registered nurse anesthetists (&#147;CRNAs&#148;), anesthesiologist assistants (&#147;AAs&#148;)
and other clinicians to provide high quality, cost efficient and service-oriented anesthesia care to our patients. Our anesthesiologists are board-certified, or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">eligible-to-apply-for-certification,</FONT></FONT></FONT></FONT> physicians who are responsible for administering anesthesia to relieve pain and for managing vital life functions during
surgery, including breathing, heart rhythm and blood pressure. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">As an integral part of the surgical team, our affiliated
anesthesiologists support the surgeons by providing medical care before, during and after surgery so that surgeons may concentrate on the surgical procedure. Our affiliated anesthesiologists provide this care by evaluating the patient and consulting
with the surgical team before surgery, providing pain control and support of life functions during surgery, supervising care after surgery by maintaining the patient in a comfortable state during recovery and discharging the patient from the
post-anesthesia care unit. They also support other departments within the hospital such as labor and delivery, imaging and the hospital&#146;s emergency room. In addition to their board certification in anesthesiology, many of our affiliated
anesthesiologists have completed fellowships in subspecialties such as obstetrical, critical care, cardiac and pediatric anesthesia. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Pain
Management </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We also provide acute and chronic pain management services in over 30 pain management centers through our
network of physicians and physician assistants. Our physicians are board-certified in anesthesiology or neurology and board-certified, or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap">eligible-to-apply-for-certification,</FONT></FONT></FONT></FONT> in pain medicine. This advanced training and education expands treatment options available for both acute and chronic pain sufferers. The physicians develop
treatment plans specific to the patients&#146; individual needs that include interventional techniques such as trigger point and facet injections, pain pumps, nerve stimulators, radiofrequency ablation and catheters, as well as medication
management. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Maternal-Fetal Care </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">We provide inpatient and office-based clinical care to expectant mothers and their unborn babies through our 325 affiliated maternal-fetal medicine subspecialists as well as obstetricians and other
clinicians, such as maternal-fetal nurse practitioners, certified nurse <FONT STYLE="white-space:nowrap">mid-wives,</FONT> ultrasonographers and genetic counselors. Maternal-fetal medicine subspecialists are board-certified, or <FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">eligible-to-apply-for-certification,</FONT></FONT></FONT></FONT> obstetricians who have extensive education and training
for the treatment of high-risk expectant mothers and their fetuses. Our affiliated maternal-fetal medicine subspecialists practice primarily in metropolitan areas where we have affiliated neonatologists to provide coordinated care for women with
complicated pregnancies whose babies are often admitted to a NICU upon delivery.<B> </B>We believe continuity of treatment from mother and developing fetus during the pregnancy to the newborn upon delivery has improved the clinical outcomes of our
patients. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Pediatric Cardiology Care </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">We provide inpatient and office-based pediatric cardiology care of the fetus, infant, child and adolescent patient with congenital heart defects and acquired heart disease, as well as adults with
congenital heart defects </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">4 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
through our 110 affiliated pediatric cardiologist subspecialists and other related clinical professionals such as pediatric nurse practitioners, echocardiographers, other diagnostic technicians,
and exercise physiologists. Pediatric cardiologists are board-certified, or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">eligible-to-apply</FONT></FONT> for certification, pediatricians who have additional education and training
in congenital heart defects and pediatric acquired heart disorders. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We provide specialized cardiac care to the fetus,
neonatal and pediatric patients with congenital and acquired heart disorders, as well as adults with congenital heart defects, through scheduled office visits, hospital rounds and immediate consultation in emergency situations. Our affiliated
pediatric cardiologists work collaboratively with neonatologists and maternal-fetal medicine subspecialists to provide a coordinated continuum of care. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Other Pediatric Subspecialty Care </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our network includes other pediatric
subspecialists such as pediatric intensivists, pediatric hospitalists, pediatric surgeons and pediatric ear, nose and throat physicians. In addition, our affiliated physicians seek to provide support services in other areas of hospitals,
particularly in the pediatric emergency room, labor and delivery area, and nursery and pediatric departments, where immediate accessibility to specialized care may be critical. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Pediatric Intensive Care</I></B>. Pediatric intensivists are hospital-based pediatricians with additional education and training in
caring for critically ill or injured children and adolescents. We have 175 affiliated physicians who provide this clinical care. They staff and manage pediatric intensive care units (&#147;PICUs&#148;) at approximately 55 hospitals. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Pediatric Hospitalists</I></B>. Pediatric hospitalists are hospital-based pediatricians specializing in inpatient care and
management of acutely ill children. We have 130 affiliated hospital-based physicians who provide inpatient pediatric and newborn care as well as provide care in PICUs, NICUs and pediatric emergency rooms at approximately 40 hospitals. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Pediatric Surgery</I></B>. Pediatric surgeons provide specialized care for patients ranging from newborns to adolescents, for all
problems or conditions that require surgical intervention, and often have particular expertise in the areas of neonatal, prenatal, trauma, and pediatric oncology. We have 20 affiliated physicians in this subspecialty including pediatric urologists,
pediatric plastic and craniofacial surgeons and general and thoracic pediatric surgeons. Areas of particular expertise include management of neonatal and congenital anomalies, prenatal counseling, trauma management, pediatric oncology,
gastrointestinal surgery, as well as common pediatric surgical conditions. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Other Newborn and Pediatric
Care</I></B><I>.</I><B><I> </I></B>Because our affiliated physicians and advanced nurse practitioners generally provide hospital-based coverage, they are situated to provide highly specialized care to address medical needs that may arise during a
baby&#146;s hospitalization. For example, as part of our ongoing efforts to support and partner with hospitals and the local referring physician community, our affiliated neonatologists, pediatric hospitalists and advanced nurse practitioners
provide <FONT STYLE="white-space:nowrap">in-hospital</FONT> nursery care to newborns through our newborn nursery program. This program is made available for babies during their hospital stay, which in the case of healthy babies typically consists of
evaluation and observation, following which they are referred, and their hospital records are provided, to their pediatricians or family practitioners for <FONT STYLE="white-space:nowrap">follow-up</FONT> care. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Newborn Hearing Screening Program</I></B><I>. </I>Our affiliated physicians also oversee our newborn hearing screening program.
Since we launched this program in 1994, we believe that we have become the largest provider of newborn hearing screening services in the United States. In 2017, we screened over 855,000 babies for potential hearing loss at 435 hospitals across the
nation. Over 40 states either require newborns to be screened for potential hearing loss before being discharged from the hospital or require that parents be offered the opportunity to submit their newborns to hearing screens. We contract or
coordinate with hospitals to provide newborn hearing screening services. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">5 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Radiology and Teleradiology </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B><I>Radiology.</I></B><I> </I>We provide radiology services including diagnostic imaging, interventional radiology and nuclear medicine through a network of 285 physicians. We believe that we bring a
unique value proposition to radiology physician groups, in that we can provide practice support, a technology platform enabling radiology to be practiced at a national level, as well as teleradiology capabilities that can enhance their efficiency,
provide subspecialty access and help them grow and remain competitive. In addition, we believe that radiology physicians in a group practice can complement the staffing needs for our teleradiology services business during certain times, such as
nights and weekends, when they are not providing services at their practices. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Teleradiology. </I></B>Teleradiology
represents a component of the broader radiology industry whereby radiographic images are transmitted from one location to another for interpretation. Through our vRad business, we provide teleradiology services to approximately 2,100 client
hospitals, health systems and radiology groups across all 50 states, the District of Columbia and Puerto Rico. With 445 U.S. board-certified and eligible radiologists currently reading images in the network, the majority of whom are subspecialty
trained, we are able to interpret over 6.3&nbsp;million patient studies annually and process over 2.1&nbsp;billion images on what we believe is the world&#146;s largest and most advanced telemedicine platform. We believe that the teleradiology
specialty is poised for growth and that there are numerous opportunities for cross-selling vRad&#146;s services within MEDNAX&#146;s existing customer base. We believe that teleradiology will play a significant role in the practice of radiology in
the future. Our teleradiology business has begun to identify opportunities throughout the country for our radiology physician group practices to expand their presence, and we believe this will be a key differentiator as we continue down the path of
building a broader radiology business in the future. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Management Services Organization and Consulting Services </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In addition to our national physician network, we provide services nationwide to healthcare facilities and physicians, including ours,
through complementary businesses, consisting of a management services organization that offers full-service revenue cycle management solutions and innovative technology used for patient/physician connectivity as well as a consulting services
company. Our management services organization provides a suite of solutions including a range of patient access and communications, full-service revenue cycle management, consulting and analytics services, billing and coding, patient responsibility,
eligibility and disability, complex accounts receivable services such as workers&#146; compensation, <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-state</FONT></FONT> Medicaid eligibility and more, and mobile-first
engagement and communication software for patients and providers. Our solutions are designed to engage patients, empower physicians and hospitals and other healthcare providers and improve financial outcomes throughout the entire healthcare
continuum. We provide these services at more than 2,400 hospitals and other healthcare providers nationwide. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our
perioperative consulting company is comprised of a collaborative team of anesthesiologists, operating room nurse executives and perioperative business strategists who develop and provide solutions to optimize the performance, resources and capacity
within hospital operating rooms and across the care continuum. Our services include strategic assessments and transformations, central sterile redesign, physician engagement and governance, and staffing/workforce support. With our <FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">peer-to-peer</FONT></FONT> consulting model, we partner with our clients to deliver sustainable and actionable results with the goal of streamlining patient throughput, enhancing anesthesia
service levels, increasing surgeon and patient satisfaction, decreasing costs and implementing strategic perioperative growth plans to hospitals and health systems. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Clinical Research and Quality </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">As part of our ongoing commitment to
improving patient care through evidence-based medicine, we also conduct clinical research, monitor clinical outcomes and implement clinical quality initiatives with a view to improving patient outcomes, shortening the length of hospital stays and
reducing long-term health system costs. Our physician-centric approach to clinical research and continuous quality improvement has demonstrated </FONT></P>
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improvements in clinical outcomes, while reducing the costs of care associated with complications as well as variability in protocols. We believe that referring and collaborating physicians,
hospitals, third-party payors and patients all benefit from our clinical research, education and quality initiatives. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>DEMAND FOR OUR
SERVICES </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Hospital-Based Care. </I></B>Hospitals generally must provide cost-effective, quality care in order to
enhance their reputations within their communities and desirability to patients, referring and collaborating physicians and third-party payors. In an effort to improve outcomes and manage costs, hospitals typically employ or contract with physician
specialists to provide specialized care in many hospital-based units or settings. Hospitals traditionally staff these units or settings through affiliations with local physician groups or independent practitioners. However, management of these units
and settings presents significant operational challenges, including variable admissions rates, increased operating costs, complex reimbursement systems and other administrative burdens. As a result, some hospitals choose to contract with physician
organizations that have the clinical quality initiatives, information and reimbursement systems and management expertise required to effectively and efficiently operate these units and settings in the current healthcare environment. Demand for
hospital-based physician services, including neonatology and anesthesiology, is determined by a national market in which qualified physicians with advanced training compete for hospital contracts. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Neonatal Medicine</I></B><B>.</B> Of the approximately 4&nbsp;million births in the United States annually, we estimate that
approximately 14% require NICU admission. Numerous institutions conduct research to identify potential causes of premature birth and medical complications that often require NICU admission. Some common contributing factors include the presence of
hypertension or diabetes in the mother, lack of prenatal care, complications during pregnancy, drug and alcohol abuse and smoking or poor nutritional habits during pregnancy. Babies admitted to NICUs typically have an illness or condition that
requires the care of a neonatologist. Babies who are born prematurely or have a low birth weight often require neonatal intensive care services because of an increased risk for medical complications. We believe obstetricians generally prefer to
perform deliveries at hospitals that provide a full complement of labor and delivery services, including a NICU staffed by board-certified, or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap">eligible-to-apply-for-certification,</FONT></FONT></FONT></FONT> neonatologists. Because obstetrics is a significant source of hospital admissions, hospital administrators have responded to these demands by establishing
NICUs and contracting with independent neonatology group practices, such as our affiliated professional contractors, to staff and manage these units. As a result, NICUs within the United States tend to be concentrated in hospitals with higher
volumes of births. There are approximately 5,600 board-certified neonatologists in the United States. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Anesthesia
Medicine.</I></B><B> </B>An estimated 50&nbsp;million inpatient procedures and 35&nbsp;million ambulatory procedures are performed annually in the United States. Anesthesiologists generally provide or participate in the administration of anesthetics
in these procedures. According to the U.S. Census Bureau, the U.S. population continues to expand and the fastest-growing segment of the population consists of individuals over the age of 65. The growth in population and, in particular the age 65 or
greater segment, has resulted in an increase in demand for surgical services and a correlating increase in demand for anesthesia services. The growth of ambulatory surgical centers and expansion of office-based procedures has also contributed to the
demand for anesthesia providers. There are approximately 51,000 board certified/eligible anesthesiologists in the United States. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B><I>Pain Management. </I></B>According to the American Academy of Pain Medicine, more than 75&nbsp;million people suffer from pain and 15% of those who suffer from pain will consult with a pain
specialist. As the population ages, we believe that the number of people suffering from acute or chronic pain will continue to increase. Lifestyle also plays an important part in the demand for pain management services. We believe that the
combination of the growing population of people who suffer from pain, the lifestyle expectations of this population and the ability for patients to seek out a pain specialist without having to be referred by a physician will increase the demand for
pain management services. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Maternal-Fetal Medicine</I></B><B>.</B> Expectant mothers with pregnancy complications often
seek or are referred by their obstetricians to maternal-fetal medicine subspecialists. These subspecialists provide inpatient and office-</FONT></P>
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based care to women with conditions such as diabetes, heart disease, hypertension, multiple gestation, recurrent miscarriage, family history of genetic diseases, suspected fetal birth defects and
other complications during their pregnancies. We believe that improved maternal-fetal care has a positive impact on neonatal outcomes. Data on neonatal outcomes demonstrates that, in general, the likelihood of mortality or an adverse condition or
outcome (referred to as &#147;morbidity&#148;) is reduced the longer a baby remains in the womb. There are approximately 2,200 board-certified maternal-fetal medicine subspecialists in the United States. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Pediatric Cardiology Medicine</I></B><B>. </B>Pediatric cardiologists provide inpatient and office-based cardiology care of the
fetus, infant, child, and adolescent with congenital heart defects and acquired heart disease, as well as providing care to adults with congenital heart defects. We estimate that approximately one in every 125 babies is born with some form of heart
defect. With advancements in care, there are approximately 1.4&nbsp;million adults in the United States today living with congenital heart disease. There are approximately 2,500 board-certified pediatric cardiologists in the United States.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Other Pediatric Subspecialty Medicine</I></B><B>.</B> Other areas of pediatric subspecialty medicine are closely
associated with maternal-fetal-newborn medical care. For example, pediatric intensivists are subspecialists who care for critically ill or injured children and adolescents in PICUs. There are approximately 1,950 board-certified pediatric
intensivists in the United States. As another example, pediatric hospitalists are pediatricians who provide care in many hospital areas, including labor and delivery and the newborn nursery. In addition, pediatric surgeons provide specialized care
for patients ranging from newborns to adolescents, for all problems or conditions affecting children that require surgical intervention, and often have particular expertise in the areas of neonatal, prenatal, trauma, and pediatric oncology. There
are approximately 970 board-certified pediatric surgeons in the United States. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Radiology. </I></B>Radiology is the
science that uses a variety of medical imaging to diagnose injury and disease and sometimes treat diseases in the body. A variety of imaging techniques such as <FONT STYLE="white-space:nowrap">X-ray,</FONT> radiography, ultrasound, computed
tomography (CT), nuclear medicine, including positron emission tomography (PET), and magnetic resonance imaging (MRI) are used. Interventional radiology is the performance of typically minimally invasive medical procedures with the guidance of
imaging technologies. According to the U.S. Census Bureau, the U.S. population continues to expand and the fastest-growing segment of the population consists of individuals over the age of 65. The growth in population and, in particular the age 65
or greater segment, is expected to result in an increase in demand for radiology services as the increased medical needs of this population require more imaging. There are approximately 30,000 board-certified radiologists in the United States.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Teleradiology and Telemedicine</I></B><B>.</B> Teleradiology is the transmission of radiographic images from one
location to another for interpretation. Teleradiology represents a component of the broader radiology industry. Within this market, teleradiology is a fast growing segment of the physician services sector. We believe that there are several factors
prompting growth of the teleradiology model. <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">Around-the-clock</FONT></FONT> subspecialty coverage is becoming a standard of care; the idea that a general radiologist practicing in a
single hospital has the ability to read all types of images is no longer prevalent. On behalf of their patients, healthcare facilities increasingly seek to have diagnostic images evaluated by radiologists who have expertise in specific subspecialty
areas such as neuroradiology, cardiac imaging and vascular surgery. In addition, facilities wish to have this subspecialty service available to them immediately because timing is critical for treatment and recovery. Advances in technology now make
this <FONT STYLE="white-space:nowrap">around-the</FONT> clock expert attention possible; using remote/onsite integration and data analytics, teleradiologists can read diagnostic images from anywhere at any time and seamlessly deliver results. This
not only provides the ability to determine optimal treatment decisions for the patient, but also enhances a healthcare facility&#146;s ability to efficiently and effectively meet its patients&#146; needs. Since most teleradiology work is completed
remotely, the pool of qualified radiologists who are subspecialty trained is significantly greater than would be available in a single geographic area. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Another key driver, we believe, is how we support forward-thinking radiology groups that are attempting to become high-performance providers in their markets. Traditionally, radiology groups have had to
staff to their </FONT></P>
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peak volume creating periods where they are overstaffed as volume ramps up or down. With us as a partner, radiology groups can staff to meet typical demand, as opposed to overstaffing, and
leverage our solutions for additional coverage at all times, not just the overnight hours. Likewise, radiology groups can more quickly expand their services to other geographies and locations with us as a partner reducing or eliminating the time it
takes to recruit physicians for growth. Similarly, teleradiology coverage can be provided for other physician group staffing challenges such as physician retirement and attrition, or to provide expertise in specific subspecialty areas that may not
be covered by the physicians in the practice. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Further, we believe there are broader applications across the larger
telemedicine industry for the use of the proprietary technology and workflow platform utilized within our teleradiology business.&nbsp;&nbsp;&nbsp;&nbsp;Telemedicine services are well documented as high quality, safe and efficient means of expanding
physician services into metropolitan and rural communities. We have begun to expand our services to provide these remote programs to our hospital partners and believe that this will become more relevant as more healthcare providers integrate remote
healthcare solutions into their healthcare practices. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Physician Practice Administration. </I></B>Administrative demands
and cost containment pressures from a number of sources, principally commercial and government payors, make it increasingly difficult for physicians to effectively manage patient care, remain current on the latest procedures and efficiently
administer <FONT STYLE="white-space:nowrap">non-clinical</FONT> activities. As a result, we believe that physicians remain receptive to being affiliated with larger organizations that reduce administrative burdens, achieve economies of scale and
provide value-added clinical research, education and quality initiatives. By relieving many of the burdens associated with the management of a subspecialty group practice, we believe that our practice administration services permit our affiliated
physicians to focus on providing quality patient care and thereby contribute to improving patient outcomes, ensuring appropriate length of hospital stays and reducing long-term health system costs. In addition, our national network of affiliated
physician practices, modeled around a traditional group practice structure, is managed by a <FONT STYLE="white-space:nowrap">non-clinical</FONT> professional management team with proven abilities to achieve significant operating efficiencies in
providing administrative support systems, interacting with physicians, hospitals and third-party payors, managing information systems and technologies, and complying with applicable laws, rules and regulations. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Management Services / Full-Service Revenue Cycle Management. </I></B>Our management services organization is designed to help
physicians and other healthcare providers better engage patients throughout the entire healthcare continuum by addressing the various challenges that they face from the complexity of reimbursement and practice coordination in today&#146;s healthcare
environment. We believe our suite of solutions sets our management services organization apart in the world of healthcare revenue cycle management. Our suite of solutions includes a range of patient access and communications, revenue cycle
management, consulting and analytics services, billing and coding, patient responsibility, eligibility and disability, complex accounts receivable services such as workers&#146; compensation, <FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap">out-of-state</FONT></FONT> Medicaid eligibility and more, as well as offering advanced technology solutions through mobile-first engagement and communication software for patients and providers. By allowing our
organization to step in and handle these areas, hospitals and other healthcare providers can focus on providing care to their patients without the administrative burdens. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The healthcare landscape is changing rapidly, particularly in various areas that hospitals and other healthcare providers typically have not invested in. Our solutions become even more relevant in these
specific areas. For example, as patient responsibility balances continue to grow and become harder to collect, our management services organization&#146;s unique process of patient outreach and communication, before the healthcare bills are even
sent, is a proven solution to this problem that also enhances patient satisfaction. Our management services organization also helps hospitals and other healthcare providers streamline the eligibility process for Medicaid. Medicaid eligibility is not
a simple process to establish, as it differs across states and must be reestablished monthly, and is a critical function as there are millions of individuals who are eligible for Medicaid. We believe that our solutions have been positively received
by our hospital and other healthcare partners, and add to the value proposition that we can deliver to address the key areas where hospitals and other healthcare providers must adapt to the changes in the business of healthcare. </FONT></P>
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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>OUR BUSINESS STRATEGY </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Our business objective is to enhance our position as a leading provider of physician and other complementary healthcare services. The key elements of our strategy to achieve this objective are:
</FONT></P> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Build upon core competencies</I></B><I>.</I> We have developed significant administrative expertise relating to our practice physician services.
We have also facilitated the development of a clinical approach to the practice of medicine among our affiliated physicians through clinical data warehouses that include research, education and quality initiatives intended to advance the practice of
medicine and care, improve the quality of care provided to our patients and reduce long-term health system costs. Analysis of the data within our clinical data warehouses across our neonatology, anesthesia and other pediatric subspecialty services
allows us to provide feedback to our physicians and hospital partners and to develop and implement best practices, all with the goal of improving outcomes, creating efficiencies and ensuring patient satisfaction. As healthcare organizations are
expected to increasingly be held accountable for the quality and cost of the care they provide, we believe that our ability to capture this data within our clinical data warehouses adds value to our patients and our hospital and physician partners.
</FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Promote same-unit and organic growth</I></B><B>.</B> We seek opportunities for increasing revenue from our hospital- and office-based operations.
For example, our affiliated hospital-based neonatal, maternal-fetal and other pediatric physicians are well situated to, and, in some cases, provide physician services in other departments, such as pediatric emergency rooms, newborn nurseries, or in
situations where immediate accessibility to specialized obstetric and pediatric care may be critical. Our hospital-based and office-based physicians continue to pursue an organic growth strategy that involves working with our hospital partners to
develop integrated service programs for which we become a provider of solutions across the maternal-fetal, newborn, pediatric continuum of care. An integrated program results in a broader offering of care across our specialties and permits the
extension of our service lines in our markets. We have successfully executed this organic growth strategy and market partnership in many metropolitan areas and intend to continue this growth initiative in the future. In addition, we market our
capabilities to obstetricians, pediatricians and family physicians to attract referrals to our hospital-based units and our office-based practices. We also market the services of our affiliated physicians to other hospitals to attract maternal,
neonatal and pediatric transport admissions. In addition, we may pursue new contractual arrangements with hospitals, including possibly through joint ventures, either where we currently provide or do not currently provide physician services.
</FONT></P></TD></TR></TABLE> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We have had success developing other programs with our hospital partners. One of these
programs relates to obstetric hospitalists (&#147;OB hospitalists&#148;) whereby we have collaborated with hospitals to design programs for which an OB hospitalist is on site at the hospital on a shift basis to provide care for laboring patients and
managing obstetrical emergencies. We believe this program is valuable to our hospital partners as the program improves patient safety in part by preventing unattended deliveries and allowing for swifter emergency treatment. An additional benefit
from such a program for our hospital partners is that local obstetricians unable to attend deliveries can be confident that there are dedicated <FONT STYLE="white-space:nowrap">in-house</FONT> obstetricians available to attend such deliveries, and
they may therefore choose to deliver at hospitals with such programs. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We also continue to expand our services
in telemedicine, which is the use of telecommunication and information technology in order to provide clinical healthcare at a distance. Our acquisition of vRad was a significant milestone in this rapidly evolving area of healthcare and provided us
with vRad&#146;s proprietary technology and workflow platform. Similarly, we expect that many pediatric subspecialties as well as maternal-fetal medicine, will benefit in the future from having a robust platform in telemedicine. Telemedicine
services are well documented as high quality, safe and efficient means of expanding physician services into metropolitan and rural communities. We have begun to expand our services to provide these remote programs to our hospital partners. These
programs enhance the standing of our hospital partners while creating another portal of entry of pediatric patients to our inpatient service lines. </FONT></P>
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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Additionally, with the goal of further expanding our organic growth
strategy, we are continuing the evolving process of developing our national sales team to pursue opportunities across our service lines by employing a targeting strategy with a specific focus and prioritization. This sales team will work with
existing hospital and other healthcare partners and will also focus on building new relationships with hospitals and other service providers to which we do not currently provide services in order to offer clinical and other solutions and respond to
requests for proposals. The ultimate goal is for MEDNAX to be viewed by hospitals and other partners as a multi-specialty health solutions partner and other complementary services solutions provider across all of our service lines. During 2017, the
management of our organic growth initiatives was moved to our business development team in order to optimally align our growth efforts. </FONT></P> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Acquire physician practice groups. </I></B>We continue to seek to expand our operations by acquiring established physician practices in our
specialties which include radiology, neonatology, anesthesiology, maternal-fetal medicine and pediatric cardiology. We also pursue complementary pediatric subspecialty physician groups, such as pediatric intensivists, pediatric hospitalists,
pediatric surgeons, pediatric ear, nose and throat physicians and pediatric ophthalmologists. In addition, both independently and in collaboration with our hospital partners, we are actively pursuing expansion into additional pediatric
subspecialties in order to meet the needs of our hospital partners. These include groups with expertise in pediatric orthopedics and neurosurgery as well as newborn congenital heart disease. During 2017, we added ten physician group practices,
including four radiology practices, two maternal-fetal medicine practices, one neonatology practice, one pediatric multi-specialty practice and two other pediatric subspecialty practices. </FONT></P></TD></TR></TABLE>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We also believe that teleradiology will play a significant role in the practice of radiology in the future and that our
teleradiology services business will be a valuable asset to us as we continue working toward our goal of building a national radiology physician group. We believe we bring a unique value proposition to radiology physician groups, in that we can
provide not only practice support, but also teleradiology capabilities that can enhance their efficiency, provide increased subspecialty access and help them grow, remain competitive and meet the ever increasing needs of their hospital partners,
payors and regulatory bodies. </FONT></P> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Acquire complementary service businesses. </I></B>In addition to growing our national physician practice network, we have expanded the service
offerings within our management services organization. Our management services organization is a technology-enabled services organization that improves financial outcomes for our hospital partners and other medical providers by enhancing the patient
experience and expanding their access to healthcare. We provide a suite of solutions across the areas of healthcare eligibility, billing and coding, assistance with patient responsibility balances, complex accounts receivable services in the areas
of third-party liability, <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-state</FONT></FONT> Medicaid eligibility and workers&#146; compensation, as well as innovative technology solutions for patient engagement, provider
productivity and communication and engagement. Our service offerings function not only as support for our own physician practices but as a revenue-generating outsourced service capability. We believe our service offerings help to address the
evolving needs of our hospital partners and other customers while creating expanded opportunities for cross-selling our services in order to supplement our future growth. We will continue to evaluate expansion of our service offerings in this area
as our hospital partners&#146; and other healthcare providers&#146; needs evolve. </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Strengthen and broaden relationships with our partners</I></B><B>.</B> By managing many of the operational challenges associated with physician
practices, encouraging clinical research, education and quality initiatives, and promoting timely intervention by our physicians, we believe that our business model is focused on improving the quality of care delivered to patients, promoting the
appropriate length of their hospital stays and optimizing efficient use of health system resources. We believe that referring and collaborating physicians, hospitals, third-party payors and patients all benefit to the extent that we are successful
in implementing our business model. In addition, we will continue to concentrate efforts in becoming more responsive and proactive in broadening our existing hospital relationships to expand
</FONT></P></TD></TR></TABLE>
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the scope of services that we provide across all specialties. We believe this will be critical as hospitals and health systems seek to expand their service offerings and as the broader healthcare
market seeks new solutions to operate more efficiently. </P></TD></TR></TABLE> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>CLINICAL RESEARCH, EDUCATION AND QUALITY </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As part of our patient focus and ongoing commitment to improving patient care through evidenced-based medicine, we engage in clinical research,
continuous quality improvement, safety and education initiatives. We discover, understand and teach healthcare practices that enhance the abilities of clinicians to deliver quality care, thereby contributing to better patient outcomes and reduced
long-term health system costs. Our investment in these initiatives benefits our patients, clinicians, referring and collaborating physicians, hospital partners and third-party payors. We believe that these initiatives help us, among other things, to
enhance the value of our services, attract new and retain existing clinicians, improve clinical operations and enhance practice communication. </P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"><B><I>Clinical Research.</I></B> We conduct clinical research to discover ways to improve clinical care for our patients and share our discoveries throughout the medical community through submissions to peer-reviewed
literature. During 2017 alone, our affiliated physicians published more than 60 articles in peer reviewed journals. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top">Neonatal medicine was the focus of 20 of the published articles. Truly understanding the outcome and the cost of achieving that outcome in a neonate requires years of follow up, but defining and measuring value is of
great importance as it focuses efforts on improving the quality of healthcare. We have continued our collaboration with neonatal healthcare providers who want to solve important clinical questions using information from our clinical data warehouse.
</TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top">In maternal-fetal medicine, our Obstetrix Collaborative Research Network along with our affiliated physicians completed and published two multicenter studies and a total of 12 studies in major peer review journals
during 2017. Our pediatric cardiology research continues to rapidly develop. Our groups are currently evaluating the role of newborn screening for congenital cardiac disease in collaboration with many of our neonatology practices. This study
completed enrollment of more than 6,000 infants and is under peer review. Many of our affiliated pediatric cardiology practices are involved in a variety of important collaborative research studies as part of both regional and national projects.
Among these projects is our involvement in a decade long multicenter partnership with other children&#146;s hospitals, funded by the American Heart Association, assessing health related quality of life outcomes in children with congenital and
acquired heart disease. Our cardiology team is a member of the prestigious Pediatric Heart Network, a subsidiary of the National Heart Lung Blood Institute, an organization that evaluates the use of certain drugs following surgical procedures for
children with complex congenital heart defects in order to improve exercise performance. In anesthesiology, we both conduct and support clinical research across a spectrum of clinical efficacy, quality, therapeutic and device investigations, all
with the goal of bringing better care to our patients. Our findings are shared throughout the medical community through peer-reviewed literature, presentation at national medical meetings and through educational venues. </TD></TR></TABLE>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">Our anesthesiology practices are currently engaged in more than 50 clinical trials in a variety of specialty
areas across eight states. These range from anesthesia investigator initiated to quality/hospital database inquiry to industry-sponsored trials. We currently continue to report quality metrics via a Centers for Medicare&nbsp;&amp; Medicaid Services
(&#147;CMS&#148;) certified Qualified Clinical Data Registry (&#147;QCDR&#148;) and to perform advanced analytics for research purposes using our quality initiative tool, Quantum Clinical Navigation System (&#147;Quantum.&#148;) This database
currently has over 1,000,000 audited patient encounters that enable us to illustrate and investigate best practices in anesthesia care in community based healthcare systems. Papers utilizing data from Quantum have been published while others are in
submission, and clinical trial results are now </P></TD></TR></TABLE>
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being accepted for publication. In addition, multiple presentations, some using abstracts from published papers, were given at national, regional and local meetings. We are well positioned to
attract clinical trial sponsors, given our rich patient base and our pool of physician investigators. </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">In radiology, we have developed data analytic capabilities utilizing the radiology studies within our extensive database to evaluate information and
provide evidence-based insights to key decision makers at healthcare systems regarding imaging utilization and clinical outcomes. Our radiology data provides us the ability to analyze disparate data and synthesize this into actionable findings.
Through the use of this data, we have the insight to measure and demonstrate clinical quality, value and performance to our customers and third-party payors. </FONT></P></TD></TR></TABLE>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Continuous Quality Improvement</I></B><I>.</I> Continuous quality improvement (&#147;CQI&#148;) initiatives are important for all of our
physician specialties. As part of our dedication to improving quality across our affiliated practices, we provide our clinicians with the opportunity to collaborate and share best practices and facilitate access to valuable information, resources
and professional development tools. From these collaborations, our affiliated physicians can identify areas for improvement, and then systematically monitor, study, learn, and implement change. There are several complex initiatives that are derived
and based on our long-standing CQI efforts, such as our Regional Resource Teams, our National High Reliability Organization (&#147;HRO&#148;) program and our Performance Improvement Teams. For anesthesia care, we have launched a new Comprehensive
Recovery After Surgery program and continue to offer a CMS certified QCDR. Our quality metrics are analyzed to include standard clinical outcome reporting, trend analysis and threshold performance, all of which are provided to our individual
physicians. The quality committees and medical directors of the practices manage quality improvement programs and drive best practices that are adapted to the needs of the local care setting. </FONT></P></TD></TR></TABLE>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Patient Safety Organization. </I></B>We have established a federally listed Patient Safety Organization (&#147;PSO&#148;), the mission of which
is to improve the quality and safety of care rendered by our clinical providers through the collection and analysis of quality data. As a federally listed PSO, our mission to improve the safety of care rendered is supported by the dissemination of
best practices information and implementation of patient safety programs. In 2017, we expanded the anesthesiology HRO program and launched the women&#146;s and children&#146;s HRO program, both aiming to provide &#147;Just Culture&#148; training to
our clinicians. The complex curriculum has been customized to meet our affiliated physician practices&#146; needs and is based on principles outlined by the Agency for Healthcare Research and Quality (&#147;AHRQ&#148;), Institute for Healthcare
Improvement, National Patient Safety Foundation and Team STEPPS, the teamwork system developed by the AHRQ and the Department of Defense. </FONT></P></TD></TR></TABLE> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">In addition to our HRO initiatives in 2017, we have also expanded our inter-professional simulation program to include additional subspecialties and have been granted a two year provisional accreditation
by the Society for Healthcare Simulation. The effects of simulation are proven as a performance improvement method and are known to lead to enhanced communication and improved patient outcomes. </FONT></P>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Continuing Medical Education</I></B>. We provide extensive continuing medical education and continuing nursing education to our affiliated
clinicians in an effort to ensure that they have access to current treatment methodologies, national best practices and evidence-based guidelines. As an Accreditation Council for Continuing Medical Education accredited provider, we offer a variety
of live and online educational credit opportunities that can be accessed on demand by our providers and are in synergy with latest research publications and healthcare industry standards. </FONT></P></TD></TR></TABLE>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We believe that these initiatives have been enhanced by our integrated national presence together with our clinical and management
information systems, which are an integral component of our clinical research and education activities. See &#147;Our Information Systems.&#148; </FONT></P>
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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>PHYSICIAN PRACTICE GROUP ADMINISTRATION </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We provide multiple administrative services to support the practice of medicine by our affiliated physicians and improve operating efficiencies
of our affiliated practice groups. </P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"><B><I>Unit Management</I></B>. A senior physician practicing medicine in each neonatal, anesthesia, radiology, pediatric intensivist, maternal-fetal, pediatric cardiology and other subspecialty practice that we manage
acts as the medical director for that practice. Each medical director is responsible for the overall management of his or her practice, including staffing and scheduling, quality of care, professional discipline, utilization review, coordinating
physician recruitment and monitoring of the financial success within the practice. Medical directors also serve as a liaison with hospital administration, other physicians and the community. </TD></TR></TABLE>
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<TD ALIGN="left" VALIGN="top"><B><I>Staffing and Scheduling</I></B>. We assist with staffing and scheduling physicians and advanced practice nurses within the units and practices that we manage. For example, each NICU is staffed by at least one
specialist on site or available on call. For our affiliated anesthesia physicians, CRNAs and AAs, we employ an operational system that assists with their staffing and scheduling. We are responsible for managing and coordinating the process for the
salaries and benefits paid and provided to our affiliated physicians and practitioners. In addition, we employ, compensate and manage all <FONT STYLE="white-space:nowrap">non-medical</FONT> personnel for our affiliated physician groups.
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<TD ALIGN="left" VALIGN="top"><B><I>Recruiting and Credentialing</I></B>. We have significant experience in locating, qualifying, recruiting and retaining experienced physicians. We maintain an extensive nationwide database of neonatologists,
maternal-fetal medicine physicians, anesthesiologists and other pediatric subspecialty physicians and are working to develop such a database for radiologists. Our medical directors and physician leaders play a central role in the recruiting and
interviewing process before candidates are introduced to other practice group physicians and hospital administrators. We verify the credentials, licenses and references of all prospective affiliated physician candidates. In addition to our database
of physicians, we recruit nationally through trade advertising, referrals from our affiliated physicians and attendance at conferences. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"><B><I>Billing, Collection and Reimbursement</I></B>. We assume responsibility for assisting our affiliated physicians with contracting with third-party payors. We are responsible for billing, collection and
reimbursement for services rendered by our affiliated physicians. In all instances, however, we do not assume responsibility for charges relating to services provided by hospitals or other physicians with whom we collaborate. Such charges are
separately billed and collected by the hospitals or other physicians. We provide our affiliated physicians and other clinicians with a training curriculum that emphasizes detailed documentation of and compliant coding protocols for all procedures
performed and services provided, and we provide comprehensive internal auditing processes, all of which are designed to achieve compliant coding, billing and collection of revenue for physician services. Generally, our billing and collection
operations are conducted from our business offices located across the United States and in Puerto Rico, as well as our corporate offices. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"><B><I>Risk Management</I></B>.<B> </B>We maintain a risk management program focused on reducing risk, including the identification and communication of potential risk areas to our medical affairs staff. We maintain
professional liability coverage for our national group of affiliated healthcare professionals. Through our risk management and medical affairs staff, we conduct risk management programs for loss prevention and early intervention in order to prevent
or minimize professional liability claims. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"><B><I>Compliance</I></B>. We provide a multi-faceted compliance program that is designed to assist our affiliated practice groups in understanding and complying with the increasingly complex laws, rules and regulations
that govern the provision of healthcare services. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"><B><I>Other Services</I></B>. We also provide management information systems, facilities management, legal support, marketing support and other services to our affiliated physicians and affiliated practice groups.
</TD></TR></TABLE>
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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>OUR INFORMATION SYSTEMS </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We maintain several information systems that support our
<FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">day-to-day</FONT></FONT> operations, ongoing clinical research and business analysis. </P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"><B><I>BabySteps</I></B><B><I><SUP STYLE="font-size:85%; vertical-align:top">&reg;</SUP></I></B><B><I>. </I></B>BabySteps is a clinical electronic documentation system used by our affiliated neonatal physicians and other
clinicians to record clinical progress notes and certain laboratory and radiology reports electronically and provides a decision tree to assist them in certain situations with the selection of appropriate billing codes. </TD></TR></TABLE>
<P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"><B><I>Clinical Data Warehouse. </I></B>BabySteps enables our affiliated practices to capture a consistent set of clinical information about the patients we treat. We <FONT STYLE="white-space:nowrap">de-identify</FONT>
and transfer information from our electronic health records that reside in BabySteps to our &#147;clinical data warehouse&#148; that since inception has accumulated clinical information from more than 24&nbsp;million daily progress records relating
to over 1.3&nbsp;million neonatal health records. With comprehensive reporting tools, our physicians are able to use this information to benchmark outcomes, enhance clinical decision-making and advance best practices at the bedside. Using a variety
of clinical performance markers, our <FONT STYLE="white-space:nowrap">de-identified</FONT> data warehouse also helps us track medication and procedure interactions, link treatments to outcomes and identify opportunities to enhance patient outcomes.
Our clinical data warehouse also helps us to identify prospective clinical trials and continuous quality improvement initiatives. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"><B><I>Quantum</I></B><B><I><SUP STYLE="font-size:85%; vertical-align:top">&reg;</SUP></I></B><B><I>. </I></B>Quantum is a quality metric acquisition and database tool that has been implemented in our anesthesiology
physician practices. Quantum collects patient level data in real time through the continuum of care and includes over 1&nbsp;million audited patient encounters. Over 80 quantifiable metrics assess patient satisfaction, efficiency, physician
performance, and quality indicators. The data is then stored, analyzed and reported to physicians and hospitals. Our clinicians use the data, along with evidence-based medicine, to develop and implement best practices and standard operating
procedures, for educational programs and for providing quality metrics to our hospital partners, all with the goal of improving outcomes and efficiency and ensuring patient satisfaction. Since 2015, Quantum has been certified by CMS as a QCDR, a
reporting mechanism available for the Physician Quality Reporting System, the former CMS program initiated to promote reporting of quality measures. In 2016, we significantly increased the acquisition, data-basing and use of quality data as all of
our anesthesiology clinicians are currently reporting quality metrics for almost 2&nbsp;million patient encounters that are managed within the Quantum QCDR. In 2017, as part of the annual CMS QCDR self-nomination process, MEDNAX expanded its QCDR
inventory to also include measures relevant to radiology and interventional pain management in addressing the CMS requirements for the Merit-Based Incentive Payment System. With this expansion of specialties represented by our QCDR, CMS approved our
self-nomination for 2018 as the MEDNAX QCDR. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"><B><I>Nextgen</I></B><B><I><SUP STYLE="font-size:85%; vertical-align:top">&reg;</SUP></I></B><B>.</B> We have licensed the Nextgen Electronic Medical Record (&#147;EMR&#148;) and Electronic Patient Management
(&#147;EPM&#148;) system for our affiliated office-based physicians and other clinicians to record clinical documentation related to their patients and to manage the revenue cycle for our office-based practices. This system has the ability to
provide benefits to our office-based practices that are similar to what BabySteps provides to our neonatology practices, including decision trees to assist physicians with the selection of compliant billing codes, promotion of consistent
documentation, and data for research and education. We are continuing the process of implementing EMR and EPM in all of our office-based practices. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"><B><I>eCCAP.</I></B> Our electronic charge capture system is used to appropriately record and bill for pediatric intensive care clinicians, hospitalist clinicians and other clinical care providers. We also use
administrative data derived from this system to drive quality assurance and quality improvement programs. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Radiology Clinical Data Warehouse. </I></B>Our extensive database of aggregated and normalized radiology
studies powers our sophisticated analytics capabilities. Our analytics technology provides evidence-</P></TD></TR></TABLE>
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based insights to our own practice and to key decision makers at hospitals and healthcare systems, as well as to onsite radiology groups regarding optimal staffing, imaging utilization and
clinical outcomes, all to help them more efficiently manage their radiology service lines and practices. Our analytics tools are relevant for both hospitals trying to better manage costs and improve operating efficiencies, as well as to radiology
groups trying to demonstrate value in an increasingly challenging and evolving healthcare reimbursement environment. Our analytics tools differentiate us as a strategic partner to both existing and new clients who rely on our insight to efficiently
manage their radiology service lines and practices. </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Pediatrix University</I></B><B><I><SUP STYLE="vertical-align:baseline; position:relative; bottom:.8ex">&reg;</SUP></I></B><B><I> and American
Anesthesiology University. </I></B>In addition to providing continuing education, our <FONT STYLE="white-space:nowrap">web-based</FONT> education platforms also function as important educational adjuncts to our affiliated physician groups, providing
a rich source of ongoing medical education for our physicians and enabling physicians to discuss cases with one another through various clinical resources. In 2018, we will be transitioning our online universities to the MEDNAX<B><I><SUP
STYLE="vertical-align:baseline; position:relative; bottom:.8ex">&reg;</SUP></I></B><B><I> </I></B>Learning&nbsp;Center and expanding to incorporate all our clinical specialties. </FONT></P></TD></TR></TABLE>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our management information systems are also an integral element of the billing and reimbursement process. We maintain systems that
provide for electronic data interchange with payors that accept electronic submissions, including electronic claims submission, insurance benefits verification and claims processing and remittance advice, which enable us to track numerous and
diverse third-party payor relationships and payment methods. Our information systems provide scalability and flexibility as payor groups upgrade their payment and reimbursement systems. We continually seek improvements to our systems to expedite the
overall process, streamline information gathering from our clinical systems and improve efficiencies in the reimbursement process. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">We maintain additional information systems designed to improve operating efficiencies of our affiliated practice groups, reduce physicians&#146; paperwork requirements and facilitate interaction among our
affiliated physicians and their colleagues regarding patient care issues. Following the acquisition of a physician practice group, we implement systematic procedures to improve the acquired group&#146;s operating and financial performance. One of
our first steps is to convert a newly acquired group to our broad-based management information system. We also maintain a database management system to assist our business development and recruiting departments to identify potential practice group
acquisitions and physician candidates. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>RELATIONSHIPS WITH OUR PARTNERS </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our business model, which has been influenced by the direct contact and daily interaction that our affiliated physicians have with their
patients, emphasizes a patient-focused clinical approach that addresses the needs of our various &#147;partners,&#148; including hospitals, third-party payors, referring and collaborating physicians, affiliated physicians and, most importantly, our
patients. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Hospitals and Other Customers </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Our relationships with our hospital partners and other customers are critical to our operations. Hospitals control access to their units and operating rooms through the awarding of contracts and hospital
privileges. We have been retained by approximately 545 hospitals to staff and manage clinical activities within specific hospital-based units and other departments. Our affiliated physicians are important components of obstetric, pediatric and
surgical services provided at hospitals. Our hospital-based focus enhances our relationships with hospitals and creates opportunities for our affiliated physicians to provide patient care in other areas of the hospital. For example, our physicians
may provide care in emergency rooms, nurseries, intensive care units and other departments where access to specialized obstetric, pediatric and anesthesia care may be critical. Our hospital partners benefit from our expertise in managing critical
care units and other settings staffed with physician specialists, including managing variable admission rates, operating costs, complex reimbursement systems and other administrative burdens. We work with our hospital partners to enhance their
reputation and market our </FONT></P>
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services to referring physicians within the communities served by those hospitals. We also provide radiology physician services to hospitals and other physician groups. In addition, our
affiliated physicians work with our hospital partners to develop integrated services programs for solutions within the services we provide. Integrated programs provide our hospital partners and us with incremental growth and result in a broader
spectrum of care across our specialties and permit us to extend our patient service lines into our existing markets. Our relationships with our hospital partners are continually evolving with the goal of being viewed by them as a solutions provider
across all of our specialties. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Under our contracts with hospitals, we have the responsibility to manage, in many cases
exclusively, the provision of physician services for hospital-based units, such as NICUs, and other hospital settings. We typically are responsible for billing patients and third-party payors for services rendered by our affiliated physicians
separately from other related charges billed by the hospital or other physicians to the same payors. Some of our hospital contracts require hospitals to pay us administrative fees. Some contracts provide for fees if the hospital does not generate
sufficient patient volume in order to guarantee that we receive a specified minimum revenue level. We also receive fees from hospitals for administrative services performed by our affiliated physicians providing medical director services at the
hospital. Administrative fees accounted for 9% of our net revenue during 2017. Some of our contracts with hospitals require us to indemnify them and their affiliates for losses resulting from the negligence of our affiliated physicians. Our hospital
contracts typically have terms of one to three years which can be terminated without cause by either party upon prior written notice, and renew automatically for additional terms of one to three years unless terminated early by any party. While we
have in most cases been able to renew these arrangements, hospitals may cancel or not renew our arrangements, or reduce or eliminate our administrative fees in the future. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Third-Party Payors </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our relationships with government-sponsored or funded
healthcare programs (&#147;GHC Programs&#148;), including Medicare and Medicaid, and with managed care organizations and commercial health insurance payors are vital to our business. We seek to maintain professional working relationships with our
third-party payors, streamline the administrative process of billing and collection, and assist our patients and their families in understanding their health insurance coverage and any balances due for
<FONT STYLE="white-space:nowrap">co-payments,</FONT> <FONT STYLE="white-space:nowrap">co-insurance,</FONT> deductibles or benefit limitations. In addition, through our quality initiatives and continuing research and education efforts, we have sought
to enhance clinical care provided to patients, which we believe benefits third-party payors by contributing to improved patient outcomes and reduced long-term health system costs. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We receive compensation for professional services provided by our affiliated physicians to patients based upon rates for specific
services provided, principally from third-party payors. Our billed charges are substantially the same for all parties in a particular geographic area, regardless of the party responsible for paying the bill for our services, but the payments we
receive vary among payors. A significant portion of our net revenue is received from GHC Programs, principally state Medicaid and federal Medicare programs. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Medicaid programs, which are jointly funded by the federal government and state governments, pay for medical and health-related services for certain categories of individuals and families generally who
have low incomes or disabilities. Medicaid programs can be either standard <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">fee-for-service</FONT></FONT> payment programs or managed care programs in which states have contracted with
health insurance companies to run local or state-wide health plans with features similar to health maintenance organizations. Our compensation rates under standard
<FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">fee-for-service</FONT></FONT> Medicaid programs are established by state governments and are not negotiated. Although Medicaid rates vary across the states, these rates are generally
much lower in comparison to private-sector health plan rates. Rates under Medicaid managed care programs typically are negotiated, but are also much lower in comparison to private-sector health plan rates. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Affordable Care Act (&#147;ACA&#148;) allows states to expand their Medicaid programs to enroll more individuals through federal
payments that fund most of the cost of increasing the Medicaid eligibility income </FONT></P>
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limit from a state&#146;s historical eligibility levels to 133% of the federal poverty level. To date, 32 states and the District of Columbia have expanded Medicaid eligibility to cover this
additional low income patient population, but other states are considering expansion. All of the states in which we operate, however, already cover children in the first year of life and pregnant women if their household income is at or below 133%
of the federal poverty level. In light of changes to the ACA, some of these states may eliminate, reduce or otherwise modify expanded enrollment eligibility. See Item 1A. Risk Factors &#151; &#147;State budgetary constraints and the uncertainty over
the future Medicaid expansion could have an adverse effect on our reimbursement from Medicaid programs&#148; and &#147;The ACA and potential changes to it may have a significant effect on our business.&#148; </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Medicare is a health insurance program primarily for individuals 65 years of age and older, younger individuals with certain disabilities
and individuals with <FONT STYLE="white-space:nowrap">end-stage</FONT> renal disease. The program is available without regard to income or assets (with means-tested premiums for beneficiaries with relatively high incomes) and offers beneficiaries
different ways to obtain their medical benefits. The most common option selected today by Medicare beneficiaries is the traditional <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">fee-for-service</FONT></FONT> payment system. The
other options include managed care, preferred provider organizations, private <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">fee-for-service</FONT></FONT> and specialty plans. Medicare compensation rates are generally much lower
in comparison to private-sector health plans. Because we provide services to a wide array of patients, including Medicare beneficiaries, a portion of our patients&#146; services are reimbursed by Medicare. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In order to participate in government programs, we and our affiliated practices must comply with stringent and often complex standards,
including enrollment and reimbursement requirements. Different states also impose varying standards for their Medicaid programs. See &#147;Government Regulation&#151;Government Reimbursement Requirements.&#148; </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We also receive compensation pursuant to contracts with commercial payors that offer a wide variety of health insurance products, such as
health maintenance organizations, preferred provider organizations and exclusive provider organizations that are subject to various state laws and regulations, as well as employer-sponsored coverage subject to federal Employee Retirement Income
Security Act (&#147;ERISA&#148;) requirements. We seek to secure mutually agreeable contracts with payors that enable our affiliated physicians to be listed as <FONT STYLE="white-space:nowrap">in-network</FONT> participants within the payors&#146;
provider networks. We generally contract with commercial payors through our affiliated professional contractors. Subject to applicable laws, rules and regulations, the terms, conditions and compensation rates of our contracts with commercial
third-party payors are negotiated and often vary across markets and among payors. In some cases, we contract with organizations that establish and maintain provider networks and then rent or lease such networks to the actual payor. Our contracts
with commercial payors typically provide for discounted <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">fee-for-service</FONT></FONT> arrangements and grant each party the right to terminate the contracts without cause upon prior
written notice. In addition, these contracts generally give commercial payors the right to audit our billings and related reimbursements for professional and other services provided by or through our affiliated physicians. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">If we do not have a contractual relationship with a health insurance payor, we generally bill the payor our full billed charges. If
payment is less than billed charges, we bill the balance to the patient, subject to federal and state laws regulating such billing. Although we maintain standard billing and collections procedures with appropriate discounts for prompt payment, we
also provide discounts in certain hardship situations where patients and their families do not have financial resources necessary to pay the amount due for services rendered. Any amounts <FONT STYLE="white-space:nowrap">written-off</FONT> are based
on the specific facts and circumstances related to each individual patient account. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Referring and Collaborating Physicians </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our relationships with our referring and collaborating physicians are critical to our success. Our affiliated physicians seek to establish
and maintain professional relationships with referring physicians in the communities where they practice. Because patient volumes in our NICUs are based in part on referrals from other physicians,
</FONT></P>
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particularly obstetricians, it is important that we are responsive to the needs of referring physicians in the communities in which we operate. We believe that our community presence, through our
hospital coverage and outpatient clinics, assists referring obstetricians, office-based pediatricians and family physicians with their practices. Our affiliated physicians are able to provide comprehensive maternal-fetal, newborn and pediatric
subspecialty care to patients using the latest advances in methodologies, supporting the local referring physician community with
<FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">24-hours-a-day,</FONT></FONT></FONT> <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">seven-days-a-week</FONT></FONT> <FONT
STYLE="white-space:nowrap">on-site</FONT> or <FONT STYLE="white-space:nowrap">on-call</FONT> coverage. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our affiliated
anesthesiologists seek to establish and maintain professional relationships with collaborating physicians, such as surgeons, and other healthcare providers. Our affiliated anesthesiologists play an important role for surgeons because they provide
medical care to the patient throughout the surgical experience. This care includes evaluation of the patient prior to surgery, consultations with the surgical team, providing pain control and support of life functions during surgery and supervising
care following surgery through the discharge of the patient from the recovery unit. Accordingly, our affiliated anesthesiologists are focused on delivering quality services to enhance the reputation and satisfaction of collaborating surgeons.
</FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Affiliated Physicians and Practice Groups </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Our relationships with our affiliated physicians are important. Our affiliated physicians are organized in traditional practice group structures. In accordance with applicable state laws, our affiliated
practice groups are responsible for the provision of medical care to patients. Our affiliated practice groups are separate legal entities organized under state law as business corporations or professional associations, professional corporations,
limited liability companies and partnerships, which we sometimes refer to as our &#147;affiliated professional contractors&#148;. Each of our affiliated professional contractors is owned by a licensed physician affiliated with the Company through
employment or another contractual relationship. Our national infrastructure enables more effective and efficient sharing of new discoveries and clinical outcomes data, including best demonstrated processes, access to our sophisticated information
systems, clinical research and education. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our business corporations and affiliated professional contractors employ or
contract with physicians to provide clinical services in certain states and Puerto Rico. In most of our affiliated practice groups, each physician has entered into an employment agreement with us or one of our affiliated professional contractors
providing for a base salary and incentive bonus eligibility and typically having a term of three to seven years. We are typically responsible for billing patients and third-party payors for services rendered by our affiliated physicians and, with
respect to services provided in a hospital, separately from other charges billed by hospitals to the same payors. Each physician must hold a valid license to practice medicine in the state in which he or she provides patient care and must become a
member of the medical staff, with appropriate clinical privileges, at each hospital at which he or she practices. Substantially all the physicians employed by us or our affiliated professional contractors have agreed not to compete within a
specified geographic area during employment and for a certain period after termination of employment. Although we believe that the <FONT STYLE="white-space:nowrap">non-competition</FONT> covenants of our affiliated physicians are reasonable in scope
and duration and therefore enforceable under applicable state laws, we cannot predict whether a court or arbitration panel would enforce these covenants in any particular case. Our hospital contracts also typically require that we and the physicians
performing services maintain minimum levels of professional and general liability insurance. We negotiate those policies and contract and pay the premiums for such insurance on behalf of the physicians. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Each of our affiliated professional contractors has entered into a comprehensive management agreement with a subsidiary of MEDNAX as the
manager. Under the terms of these management agreements, and subject to state laws and other regulations, the manager is typically paid for its services based on the performance of the applicable practice group. See &#147;Government
Regulation&#151;Fee Splitting; Corporate Practice of Medicine.&#148; </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>COMPETITION </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The physician services industry is highly fragmented. Competition in our business is generally based upon a number of factors, including
reputation, experience and level of care and our affiliated physicians&#146; ability to </FONT></P>
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provide cost-effective, quality clinical care. The nature of competition for our hospital-based practices, such as neonatology, anesthesiology and radiology, differs significantly from
competition for our office-based practices. Our hospital-based practices compete nationally with other health services companies and physician groups for hospital contracts and qualified physicians. In some instances, our hospital-based physicians
also compete on a regional or local basis. For example, our neonatologists compete for referrals from local physicians and transports from surrounding hospitals. Our office-based practices, such as maternal-fetal medicine and pediatric cardiology,
compete for patients with office-based practices in those subspecialties. In addition, we compete in our teleradiology service line with other teleradiology service providers where costs to provide services may be lower and turnaround times may be
faster. We also compete directly with hospitals themselves as they may consider reading images with their own employed radiologists rather than outsource those reads to our affiliated radiologists. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Hospitals control access to their NICUs and operating rooms by awarding contracts and hospital clinical privileges, and our relationships
with our hospital partners are critical to our operations. Because our operations consist primarily of physician services provided within hospital-based units, we compete with others for contracts with hospitals to provide services. We also compete
with hospitals themselves to provide such services. Hospitals may employ neonatologists, anesthesiologists or radiologists directly or contract with other physician groups to provide services either on an exclusive or
<FONT STYLE="white-space:nowrap">non-exclusive</FONT> basis. A hospital not otherwise competing with us may begin to do so by opening a new NICU or operating facility, expanding the capacity of an existing NICU, adding operating room suites or, in
the case of neonatal services, upgrading the level of its existing NICU. If the hospital chooses to do so, it may award the contract to operate the relevant facility to a competing group or company from within or outside the surrounding community.
Our contracts with hospitals generally provide that they may be terminated without cause upon prior written notice. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The
healthcare industry is highly competitive. Companies in other segments of the industry as well as healthcare-focused and other private equity firms, some of which have financial and other resources greater than ours, may become competitors in
providing neonatal, anesthesia, radiology and teleradiology, maternal-fetal and other pediatric subspecialty care. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>GOVERNMENT REGULATION
</B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The healthcare industry is governed by a framework of federal and state laws, rules and regulations that are extensive and
complex and for which, in many cases, the industry has the benefit of only limited judicial and regulatory interpretation. The resources and costs required to comply with these laws, rules and regulations are high. If we or one of our affiliated
practice groups or service businesses is found to have violated these laws, rules or regulations, our business, financial condition and results of operations could be materially, adversely affected. The ACA made numerous changes that are having the
effect of reshaping the United States healthcare delivery system. Further healthcare reform, including potential repeal of or changes to the ACA, continues to attract significant legislative and administrative interest, legal challenges, regulatory
and compliance requirements, new approaches and public attention that create uncertainty and the potential for additional changes. Healthcare reform implementation, additional legislation or regulations, and other changes in government policy or
regulation may affect our reimbursement, restrict our existing operations, limit the expansion of our business or impose additional compliance requirements and costs, any of which could have a material adverse effect on our business, financial
condition, results of operations, cash flows and the trading price of our securities. See Item 1A. Risk Factors &#151; &#147;The ACA and potential changes to it may have a significant effect on our business.&#148; </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Licensing and Certification </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Each state imposes licensing requirements on individual physicians and clinical professionals, and on facilities operated or utilized by healthcare companies like us. Many states require regulatory
approval, including certificates of need, before establishing certain types of healthcare facilities, offering certain services or </FONT></P>
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expending amounts in excess of statutory thresholds for healthcare equipment, facilities or programs. We and our affiliated physicians are also required to meet applicable Medicare provider
requirements under federal laws, rules and regulations and Medicaid provider requirements under federal and state laws, rules and regulations. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Fee Splitting; Corporate Practice of Medicine </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Many states have laws that prohibit business corporations, such as MEDNAX, from practicing medicine, employing physicians to practice medicine, exercising control over medical decisions by physicians, or
engaging in certain arrangements, such as fee splitting, with physicians. In light of these restrictions, we operate by maintaining long-term management contracts through our subsidiaries with affiliated professional contractors, which employ or
contract with physicians to provide physician professional services. Under these arrangements, our manager subsidiaries perform only <FONT STYLE="white-space:nowrap">non-medical</FONT> administrative services, do not represent that they offer
medical services and do not exercise influence or control over the practice of medicine by the physicians employed by the affiliated professional contractors. In states where fee splitting with a business corporation or manager is prohibited, the
fees that are received from the affiliated professional contractors have been established on a basis that we believe complies with applicable laws. Although the relevant laws in these states have been subject to limited judicial and regulatory
interpretation, we believe that we are in compliance with applicable state laws in relation to the corporate practice of medicine and fee splitting. However, regulatory authorities or other parties, including our affiliated physicians, may assert
that, despite these arrangements, we or our manager subsidiaries are engaged in the corporate practice of medicine or that the contractual arrangements with the affiliated professional contractors constitute unlawful fee splitting, in which case we
could be subject to administrative, civil or criminal remedies or penalties, the contracts could be found to be legally invalid and unenforceable, in whole or in part, or we could be required to restructure our contractual arrangements with our
affiliated professional contractors. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Fraud and Abuse Provisions </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Existing federal laws, as well as similar state laws, governing Medicare, Medicaid, other GHC Programs and other <FONT
STYLE="white-space:nowrap">non-governmental</FONT> arrangements and interactions, impose a variety of fraud and abuse prohibitions on healthcare companies like us. These laws are interpreted broadly and enforced aggressively by multiple government
agencies, including the Office of Inspector General of the Department of Health and Human Services, the Department of Justice (&#147;DOJ&#148;) and various state agencies. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Federal and state fraud and abuse laws apply to and affect our financial relationships and other ordinary and common business interactions with hospitals, referring physicians and other healthcare
entities. In particular, the federal anti-kickback statute makes it a crime to knowingly and willfully solicit, receive, offer, or pay any remuneration in return for either referring items or services for which payment may be made in whole or in
part by a GHC Program or purchasing, leasing, ordering, or arranging for or recommending the purchase, lease, or ordering of any service or item for which payment may be made in whole or in part by a GHC Program. In addition, the federal physician
self-referral law, commonly known as the &#147;Stark Law,&#148; is a strict liability statute that prohibits a physician from making a referral to an entity for certain &#147;designated health services&#148; if the physician has a financial
relationship with that entity, unless an exception applies. The entity is prohibited from billing the Medicare program for designated health services furnished pursuant to a prohibited referral. These laws have been broadly interpreted by federal
courts and agencies, and potentially subject many healthcare business arrangements to government investigation, enforcement and prosecution, which can be costly and time consuming. Many of the states in which we operate also have similar
anti-kickback and self-referral laws that apply to our government and <FONT STYLE="white-space:nowrap">non-government</FONT> business. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Violations of these laws are punishable by substantial penalties and other remedies, including monetary fines, civil penalties, administrative remedies, criminal sanctions (in the case of the
anti-kickback statute), exclusion from participation in GHC Programs and forfeiture of amounts collected in violation of such laws. </FONT></P>
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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">There are a variety of other types of federal and state fraud and abuse laws, including laws
authorizing the imposition of criminal, civil and administrative penalties for submitting false or fraudulent claims for reimbursement to GHC Programs. These laws include the federal civil False Claims Act (&#147;FCA&#148;), which prohibits
knowingly presenting, or causing to be presented, false claims to GHC Programs, including Medicare, Medicaid, TRICARE (the program for military dependents and retirees), the Federal Employees Health Benefits Program, and insurance plans purchased
through the ACA insurance exchanges where payments include federal funds. Substantial civil fines and treble damages, along with other remedies, including exclusion from GHC Programs, can be imposed for violating the FCA. Furthermore, the FCA does
not require that the individual or company that presented or caused to be presented an allegedly false claim have actual knowledge of its falsity. The statute applies where the individual or company acted in &#147;reckless disregard&#148; or in
&#147;deliberate ignorance&#148; of the truth or falsity of the claim. The FCA also applies to the improper retention of identified overpayments and includes &#147;whistleblower&#148; provisions that permit private citizens to sue a claimant on
behalf of the government and share in the amounts recovered under the law. In recent years, many cases have been brought against healthcare companies by the government and by &#147;whistleblowers,&#148; which have resulted in judgments and
settlements involving substantial payments to the government by the companies involved. The cost to defend against allegations can also be substantial. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">In addition, the Civil Monetary Penalties Law imposes substantial civil monetary penalties against a person or entity that engages in other prohibited activities, such as presenting or causing to be
presented a claim to a GHC Program that the person knows or should know is for an item or service that was not provided as claimed or for a claim that is false or fraudulent, or providing remuneration to a GHC Program beneficiary that the person or
entity knows or should know is likely to influence the beneficiary&#146;s selection of a provider or supplier. Regulators also have the authority to exclude individuals and entities from participation in GHC Programs under the Civil Monetary
Penalties Law. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The civil and administrative false claims statutes are being applied in a broad range of circumstances. For
example, claims for services that are medically unnecessary or fail to meet applicable coverage standards may, under certain circumstances, violate these statutes. Claims for services that were induced by kickbacks and Stark Law violations may also
form the basis for FCA liability. Many of the laws and regulations referenced above can be used in conjunction with each other. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">If we or our affiliated professional contractors were excluded from participation in any GHC Programs, not only would we be prohibited
from submitting claims for reimbursement under such programs, but we also would be unable to contract with other healthcare providers, such as hospitals, to provide services to them. It could also adversely affect our or our affiliated professional
contractors&#146; ability to contract with, or obtain payment from, <FONT STYLE="white-space:nowrap">non-governmental</FONT> payors. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Although we intend to conduct our business in compliance with all applicable federal and state fraud and abuse laws, many of the laws, rules and regulations applicable to us, including those relating to
billing and those relating to financial relationships with physicians and hospitals, are broadly worded and may be interpreted or applied by prosecutorial, regulatory or judicial authorities in ways that we cannot predict. Accordingly, we cannot
assure you that our arrangements or business practices will not be subject to government scrutiny or be alleged or found to violate applicable fraud and abuse laws. If there is a determination by government authorities that we have not complied with
any of these laws, rules and regulations, our business, financial condition and results of operations could be materially, adversely affected. See &#147;Government Investigations.&#148; </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Government Reimbursement Requirements </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In order to participate in the
Medicare program and in the various state Medicaid programs, we and our affiliated physician practices must comply with stringent and often complex enrollment and reimbursement requirements. Moreover, different states impose varying standards for
their Medicaid programs. While our compliance program requires that we and our affiliated physician practices adhere to the laws, rules and </FONT></P>
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regulations applicable to the government programs in which we participate, our failure to comply with these laws, rules and regulations could negatively affect our business, financial condition
and results of operations. See &#147;Government Regulation&#151;Fraud and Abuse Provisions,&#148; &#147;Government Regulation&#151;Compliance Program,&#148; &#147;Government Investigations&#148; and &#147;Other Legal Proceedings,&#148; and Item 1A.
Risk Factors &#151; &#147;Government-funded programs, private insurers or state laws and regulations may limit, reduce or make retroactive adjustments to reimbursement amounts or rates,&#148; &#147;We may become subject to billing investigations by
federal and state government authorities&#148; and &#147;The healthcare industry is highly regulated, and government authorities may determine that we have failed to comply with applicable laws, rules or regulations.&#148; </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In addition, GHC Programs are subject to statutory and regulatory changes, administrative rulings, interpretations and determinations,
requirements for utilization review and new governmental funding restrictions, all of which may materially increase or decrease program payments, as well as affect the cost of providing services and the timing of payments to providers. Moreover,
because these programs generally provide for reimbursement on a <FONT STYLE="white-space:nowrap">fee-schedule</FONT> basis rather than on a charge-related basis, we generally cannot increase our revenue through increases in the amount we charge for
our services. To the extent our costs increase, we may not be able to recover our increased costs from these programs, and cost containment measures and market changes in <FONT STYLE="white-space:nowrap">non-governmental</FONT> insurance plans have
generally restricted our ability to recover, or shift to <FONT STYLE="white-space:nowrap">non-governmental</FONT> payors, these increased costs. In attempts to limit federal and state spending, there have been, and we expect that there will continue
to be, a number of proposals to limit or reduce Medicare and Medicaid reimbursement for various services. Our business may be significantly and adversely affected by any such changes in reimbursement policies and other legislative initiatives aimed
at reducing healthcare costs associated with Medicare, Medicaid and other government healthcare programs. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our business also
could be adversely affected by reductions in or limitations of reimbursement amounts or rates under these government programs, reductions in funding of these programs or elimination of coverage for certain individuals or treatments under these
programs. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Antitrust </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The healthcare industry is subject to close antitrust scrutiny. The Federal Trade Commission (&#147;FTC&#148;), the Antitrust Division of the DOJ and state Attorneys General all actively review and, in
some cases, take enforcement action against business conduct and acquisitions in the healthcare industry. Private parties harmed by alleged anticompetitive conduct can also bring antitrust suits. Violations of antitrust laws may be punishable by
substantial penalties, including significant monetary fines, civil penalties, criminal sanctions, consent decrees and injunctions prohibiting certain activities or requiring divestiture or discontinuance of business operations. Any of these
penalties could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>HIPAA and Other Privacy, Security and Breach Notification Laws </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Numerous
federal and state laws, rules and regulations govern the collection, dissemination, use, privacy, security and confidentiality of personal information. For example, the federal Health Insurance Portability and Accountability Act of 1996, as amended
(&#147;HIPAA&#148;), and its implementing regulations impose requirements to protect the privacy and security of protected health information (&#147;PHI&#148;) and to provide notification in the event of a breach of PHI. Violations of HIPAA are
punishable by civil money penalties and, in some cases, criminal penalties and imprisonment. The U.S. Department of Health and Human Services (&#147;HHS&#148;) Office for Civil Rights (&#147;OCR&#148;), which is responsible for enforcing HIPAA, also
may enter into resolution agreements or take other actions to obtain compliance and/or corrective actions to address violations of HIPAA. As part of our business operations, including in connection with medical record keeping, third-party billing,
research and other services, we and our affiliated physician practices collect and maintain PHI regarding patients, which subjects us to compliance with HIPAA requirements. </FONT></P>
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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Pursuant to HIPAA, HHS has adopted privacy regulations, known as the privacy rule, to govern
the use and disclosure of PHI (the &#147;Privacy Rule&#148;). The Privacy Rule applies to &#147;Covered Entities,&#148; which are health plans, health care clearinghouses, and health care providers that engage in standardized transactions under
HIPAA, and, as discussed further below, &#147;Business Associates,&#148; which are entities that perform functions or services for or on behalf of Covered Entities that involve the use or disclosure of PHI. A &#147;Business Associate&#148; also
includes any &#147;Subcontractor,&#148; which means any entity to whom a Business Associate delegates any function, activity or service, other than in the capacity of a member of the Business Associate&#146;s workforce. PHI is broadly defined as any
individually identifiable health information transmitted or maintained in any form, including electronic, paper or oral. As a general rule, a Covered Entity or Business Associate may not use or disclose PHI except as permitted under the Privacy
Rule. We have implemented privacy policies and procedures, including training programs, designed to comply with the requirements set forth in the Privacy Rule, including as amended to reflect changes to HIPAA under HITECH, as discussed further
below. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">HHS has also adopted data security regulations (the &#147;Security Rule&#148;) that require Covered Entities
(including health care providers) and Business Associates to implement administrative, physical and technical safeguards to protect the integrity, confidentiality and availability of individually identifiable health information that is
electronically created, received, maintained or transmitted (such as between us and our affiliated practices). We have implemented security policies, procedures and systems, including training programs, designed to comply with the requirements set
forth in the Security Rule. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In addition, Congress enacted the Health Information Technology for Economic and Clinical Health
(&#147;HITECH&#148;) Act as part of the American Recovery and Reinvestment Act. Among other changes to the laws governing PHI, HITECH strengthened and expanded HIPAA requirements, increased penalties for violations, gave patients new rights to
restrict uses and disclosures of their PHI, and imposed a number of privacy and security requirements directly on Business Associates, which are directly subject to civil and criminal penalties under HIPAA as a result of HITECH. Notably, as a result
of HITECH, a Covered Entity is liable for violations of HIPAA resulting from the acts or omissions of any Business Associate acting as its agent, as determined by the federal common law of agency. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Under HITECH, Covered Entities are required to report any unauthorized use or disclosure of PHI that meets the definition of a breach to
affected individuals, HHS and, depending on the number of affected individuals, the media for the affected market. In addition, HITECH requires that Business Associates report breaches to their Covered Entity customers. HITECH also authorizes state
Attorneys General to bring civil actions in response to violations of HIPAA that threaten the privacy of state residents. We have adopted breach notification policies and procedures designed to comply with the applicable requirements set forth in
HITECH. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">HIPAA established a federal &#147;floor&#148; with respect to privacy, security, and breach notification requirements
and does not supersede any state laws insofar as they are broader or more stringent than HIPAA. Numerous state and certain other federal laws protect the confidentiality of patient information and other personal information, including but not
limited to state medical privacy laws, state laws protecting personally identifiable information, state data breach notification laws, state genetic privacy laws, human subjects research laws and federal and state consumer protection laws.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">These requirements are also subject to change. Compliance with new privacy, security, and breach notification laws,
regulations and requirements may result in increased operating costs, and may constrain or require us to alter our business model or operations. For example, HITECH further restricted our ability to collect, disclose and use PHI and imposed
additional compliance requirements on us. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>HIPAA Transaction Requirements </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In addition to privacy, security, and breach notifications requirements, HIPAA and its implementing regulations establish uniform
electronic data transmission standards that all healthcare providers must use for </FONT></P>
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electronic healthcare transactions. For example, claims for reimbursement that are transmitted electronically to third-party payors must comply with specific formatting standards, and these
standards apply whether the payor is a government or a private entity. We report medical diagnoses under International Classification of Diseases, 10</FONT><FONT STYLE="font-family:Times New Roman" SIZE="1"><SUP
STYLE="vertical-align:baseline; position:relative; bottom:.8ex">th</SUP></FONT><FONT STYLE="font-family:Times New Roman" SIZE="2"> Edition <FONT STYLE="white-space:nowrap">(&#147;ICD-10&#148;).</FONT> If claims are not reported properly under <FONT
STYLE="white-space:nowrap">ICD-10</FONT> due to technical or coding errors or other implementation issues involving systems, including ours and those of our third-party payors, there can be a delay in the processing and payment of such claims, or a
denial of such claims, which could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Environmental Regulations </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our healthcare operations generate medical waste
that must be disposed of in compliance with federal, state and local environmental laws, rules and regulations. Our office-based operations are subject to compliance with various other environmental laws, rules and regulations. Such compliance does
not, and we anticipate that such compliance will not, materially affect our capital expenditures, financial position or results of operations. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Compliance Program </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We
maintain a compliance program that includes the established elements of an effective program and reflects our commitment to complying with all laws, rules and regulations applicable to our business and that meets our ethical obligations in
conducting our business (the &#147;Compliance Program&#148;). We believe our Compliance Program provides a solid framework to meet this commitment and our obligations as a provider of healthcare services, including: </FONT></P>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="1%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">a Chief Compliance Officer who reports to the Board of Directors on a regular basis; </FONT></P></TD></TR></TABLE>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="1%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">a Compliance Committee consisting of our senior executives; </FONT></P></TD></TR></TABLE>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="1%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">a formal internal audit function, including a Senior Director of Internal Audit who reports to the Audit Committee on a regular basis;
</FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="1%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">our <I>Code of Conduct</I>, which is applicable to our employees, independent contractors, officers and directors; </FONT></P></TD></TR></TABLE>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="1%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">our <I>Code of Professional Conduct &#150; Finance</I>, which is applicable to our finance personnel, including our Chief Executive Officer, Chief
Financial Officer and Treasurer and Chief Accounting Officer; </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="1%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">a disclosure program that includes a mechanism to enable individuals to disclose on a confidential or anonymous basis to the Chief Compliance Officer
or any person who is not in the disclosing individual&#146;s chain of command, issues or questions believed by the individual to be a potential violation of criminal, civil, or administrative laws or of company policies or procedures;
</FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="1%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">an organizational structure designed to integrate our compliance objectives into our corporate offices, divisions, regions and practices; and
</FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="1%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">education, monitoring and corrective action programs designed to establish methods to promote the understanding of our Compliance Program and adherence
to its requirements. </FONT></P></TD></TR></TABLE> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The foundation of our Compliance Program is our <I>Code of Conduct</I>, which is
intended to be a comprehensive statement of the ethical and legal standards governing the daily activities of our employees, affiliated professionals, independent contractors, officers and directors. All of our personnel are required to abide by,
and are given thorough education regarding, our <I>Code of Conduct</I>. In addition, all employees and affiliated professionals are expected to report incidents that they believe in good faith may be in violation of our <I>Code of Conduct</I>. We
maintain a toll-free helpline to permit individuals to report compliance concerns on an anonymous basis and obtain answers to questions about our <I>Code of Conduct</I>. Our Compliance Program, including our <I>Code of Conduct</I>, is administered
by our Chief Compliance Officer with oversight by our Chief Executive Officer, </FONT></P>
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Compliance Committee and Board of Directors. Copies of our <I>Code of Conduct</I> and our <I>Code of Professional Conduct &#150; Finance</I> are available on our website, www.mednax.com. Our
internet website and the information contained therein or connected thereto are not incorporated into or deemed a part of this Form <FONT STYLE="white-space:nowrap">10-K.</FONT> Any amendments or waivers to our <I>Code of Professional Conduct &#150;
Finance</I> will be promptly disclosed on our website following the date of any such amendment or waiver. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>GOVERNMENT INVESTIGATIONS
</B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We expect that audits, inquiries and investigations from government authorities, agencies, contractors and payors will
occur in the ordinary course of business. Such audits, inquiries and investigations and their ultimate resolutions, individually or in the aggregate, could have a material adverse effect on our business, financial condition, results of operations,
cash flows and the trading price of our securities. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>OTHER LEGAL PROCEEDINGS </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In the ordinary course of our business, we become involved in pending and threatened legal actions and proceedings, most of which involve
claims of medical malpractice related to medical services provided by our affiliated physicians. Our contracts with hospitals generally require us to indemnify them and their affiliates for losses resulting from the negligence of our affiliated
physicians and other clinicians. We may also become subject to other lawsuits that could involve large claims and significant defense costs. We believe, based upon a review of pending actions and proceedings, that the outcome of such legal actions
and proceedings will not have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. The outcome of such actions and proceedings, however, cannot be predicted with
certainty and an unfavorable resolution of one or more of them could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Although we currently maintain liability insurance coverage intended to cover professional liability and certain other claims, we cannot
ensure that our insurance coverage will be adequate to cover liabilities arising out of claims asserted against us in the future where the outcomes of such claims are unfavorable to us. With respect to professional liability risk, we self-insure a
significant portion of this risk through our wholly owned captive insurance subsidiary. Liabilities in excess of our insurance coverage, including coverage for professional liability and certain other claims, could have a material adverse effect on
our business, financial condition, results of operations, cash flows and the trading price of our securities. See &#147;Professional and General Liability Coverage.&#148; </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>PROFESSIONAL AND GENERAL LIABILITY COVERAGE </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We maintain professional and
general liability insurance policies with third-party insurers generally on a claims-made basis, subject to deductibles, self-insured retention limits, policy aggregates, exclusions, and other restrictions, in accordance with standard industry
practice. We believe that our insurance coverage is appropriate based upon our claims experience and the nature and risks of our business. However, we cannot predict whether any pending or future claim would be successful or, if successful, would
not exceed the limits of available insurance coverage. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our business entails an inherent risk of claims of medical malpractice
against our affiliated physicians, clinicians and us. We contract and pay premiums for professional liability insurance that indemnifies us and our affiliated healthcare professionals generally on a claims-made basis for losses incurred related to
medical malpractice litigation. Professional liability coverage is required in order for our affiliated physicians to maintain hospital privileges. Our self-insured retention under our professional liability insurance program is maintained primarily
through a wholly owned captive insurance subsidiary. We record estimates in our Consolidated Financial Statements for our liabilities for self-insured retention amounts and claims incurred but not reported based on an actuarial valuation using
historical loss information, claim emergence patterns and various actuarial assumptions. Liabilities for claims incurred but not reported are not discounted. Because many factors can affect </FONT></P>
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historical and future loss patterns, the determination of an appropriate reserve involves complex, subjective judgment, and actual results may vary significantly from estimates. If the
self-insured retention amounts and other amounts that we are actually required to pay materially exceed the estimates that have been reserved, our financial condition, results of operations and cash flows could be materially, adversely affected.
</FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>EMPLOYEES AND PROFESSIONALS UNDER CONTRACT </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">In addition to the 4,075 practicing physicians affiliated with us as of December&nbsp;31, 2017, we employed or contracted with approximately 4,150 other clinical professionals and approximately 7,675
other full-time and part-time employees. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>GEOGRAPHIC COVERAGE </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">We provide physician services across all 50 states, the District of Columbia and Puerto Rico. In addition, through our complementary service businesses, we provide full service revenue cycle management
and consulting services to healthcare facilities and physicians nationwide. During 2017, approximately 51% of our net revenue was generated by operations in our five largest states. Our operations in Texas accounted for approximately 19% of our net
revenue for the same period. Although we continue to seek to diversify the geographic scope of our operations, primarily through acquisitions of physician group practices, we may not be able to implement successfully or realize the expected benefits
of any of these initiatives. Adverse changes or conditions affecting states in which our operations are concentrated, such as healthcare reforms, changes in laws, rules and regulations, reduced Medicare or Medicaid reimbursements, an increase in the
income level required to qualify for government healthcare programs or government investigations, may have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities.
</FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>SERVICE MARKS </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We have registered with the United States Patent and Trademark Office the service marks &#147;MEDNAX National Medical Group and
Design,&#148; &#147;Pediatrix Medical Group and Design,&#148; &#147;Obstetrix Medical Group and Design,&#148; &#147;American Anesthesiology and Design,&#148; &#147;BabySteps,&#148; the &#147;Baby Design,&#148; &#147;Quality Steps,&#148;
&#147;Quantum Clinical Navigation System,&#148; &#147;iNewborn,&#148; &#147;NEO Conference and Design,&#148; &#147;MedData&#148; and &#147;vRad,&#148; among others. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>AVAILABLE INFORMATION </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our annual proxy statements, annual reports on Form <FONT
STYLE="white-space:nowrap">10-K,</FONT> quarterly reports on Form <FONT STYLE="white-space:nowrap">10-Q,</FONT> current reports on Form <FONT STYLE="white-space:nowrap">8-K</FONT> and amendments to those statements and reports filed or furnished
pursuant to Section&nbsp;13(a) or 15(d) of the Securities Exchange Act of 1934 are available free of charge and may be printed out through our internet website, <U>www.mednax.com</U>, as soon as reasonably practicable after we electronically file
such material with, or furnish it to, the SEC. Our proxy statements and reports may also be obtained directly from the SEC&#146;s Internet website at <U>www.sec.gov</U> or from the SEC&#146;s Public Reference Room at 100 F Street, N.E., Washington,
D.C. 20549. Information on the operation of the Public Reference Room can be obtained by calling <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">1-800-SEC-0330.</FONT></FONT></FONT> Our internet
website and the information contained therein or connected thereto are not incorporated into or deemed a part of this Form <FONT STYLE="white-space:nowrap">10-K.</FONT> </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">27 </FONT></P>



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<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>RISK FACTORS </B></FONT></TD></TR></TABLE> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><I>Our
business is subject to a number of factors that could materially affect future developments and performance. In addition to factors affecting our business that have been described elsewhere in this Form <FONT STYLE="white-space:nowrap">10-K,</FONT>
any of the following risks could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </I></FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Economic conditions could have an adverse effect on our business. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our
operations and performance depend significantly on economic conditions.&nbsp;During the year ended December&nbsp;31, 2017, the percentage of our patient service revenue being reimbursed under GHC Programs increased slightly as compared to the year
ended December&nbsp;31, 2016. Although economic conditions in the United States have improved since the economic downturn several years ago, we could experience additional shifts toward GHC Programs, and patient volumes could decline, if economic
conditions deteriorate. Adverse economic conditions could also lead to additional increases in the number of unemployed and under-employed workers and a decline in the number of private employers that offer healthcare insurance coverage to their
employees. Employers that do offer healthcare coverage may increase the required contributions from employees to pay for their coverage and increase patient responsibility amounts. In addition, certain private payors&#146; poor experience with the
healthcare insurance exchanges and uncertainty around the future of the ACA and healthcare insurance exchanges may result in those payors exiting the healthcare insurance exchange marketplaces or the cessation of the healthcare insurance exchanges.
As a consequence, the number of patients who participate in GHC Programs or who are uninsured or underinsured could increase. Payments received from GHC Programs are substantially less than payments received from private healthcare insurance
programs (managed care and other third-party payors). Payments under policies issued through the healthcare insurance exchanges may be less than payments from private healthcare insurance programs and in some cases, patients&#146; responsibility for
costs related to healthcare plans obtained through the healthcare insurance exchanges may be high and could increase in the future, and we may experience increased bad debt due to patients&#146; inability to pay for certain services. A payor mix
shift from private healthcare insurance programs to GHC Programs or to healthcare insurance exchanges may result in an increase in our estimated provision for contractual adjustments and uncollectibles and a corresponding decrease in our net
revenue, as well as a significant reduction in our average reimbursement rates. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>State budgetary constraints and the uncertainty over the
future of Medicaid could have an adverse effect on our reimbursement from Medicaid programs. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Congress and the current
Administration have expressed interest in repealing, and have attempted to repeal, the ACA and substantially reform the Medicaid program. In doing so, Congress may repeal the provisions of the ACA that encouraged states to expand Medicaid
eligibility to more adults, including additional federal matching funds that enabled states to do so. The ACA allowed states to expand their Medicaid programs through federal payments that fund most of the cost of increasing the Medicaid eligibility
income limit from a state&#146;s historic eligibility levels to 133% of the federal poverty level. As of December&nbsp;31, 2017, 32 states and the District of Columbia implemented the expansion of Medicaid eligibility. All of the states in which we
operate, however, already cover children in the first year of life and pregnant women if their household incomes are at or below 133% of the federal poverty level. If states that expanded Medicaid reduce or eliminate eligibility for certain
individuals, the number of patients who are uninsured could increase. Some states may seek to maintain expanded eligibility and to do so could offset the cost by further reducing payments to providers of services. In some states, we could experience
delayed or reduced Medicaid payment for services furnished to program enrollees. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Congress and the current Administration is
also considering enacting substantial reforms to Medicaid law to grant states more autonomy and discretion to design Medicaid programs. These changes, if enacted, could reduce or eliminate eligibility for certain individuals, or allow states to
reduce payments to providers of services. As a </FONT></P>
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result, in some states, we could experience an increase in the number of uninsured patients and delayed or reduced Medicaid payment for services furnished to program enrollees. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In addition, many states are continuing to collect less tax revenue than they did historically and as a consequence continue to face
budget shortfalls and underfunded pension and other obligations. Although shortfalls have been declining in more recent budgetary years, they are still significant by historical standards. The financial condition of the states in which we do
business could lead to reduced or delayed funding for Medicaid programs and, in turn, reduced or delayed reimbursement for physician services, which could adversely affect our results of operations, cash flows and financial condition. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>The birth rate in the United States may decline. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Provisional birth data for 2016 indicate that total births in the United States declined by less than 1% as compared to 2015. Although the provisional data for 2017 is not yet available, we expect that
birth trends have not materially changed. However, future declines in births are possible and could have an adverse effect on our patient volumes, net revenue, results of operations, cash flows and financial condition. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>The ACA and potential changes to it may have a significant effect on our business. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The ACA contains a number of provisions that have affected us and, absent amendment or repeal, may continue to affect us over the next
several years. These provisions include the establishment of health insurance exchanges to facilitate the purchase of qualified health plans, expanded Medicaid eligibility, subsidized insurance premiums and additional requirements and incentives for
businesses to provide healthcare benefits. Other provisions have expanded the scope and reach of FCA and other healthcare fraud and abuse laws. Moreover, we could be affected by potential changes to various aspects of the ACA, including subsidies,
healthcare insurance marketplaces and Medicaid expansion. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The ACA remains subject to continuing legislative and
administrative scrutiny, including efforts by the Republican-controlled Congress and the current Administration to amend or repeal a number of its provisions, as well as administrative actions delaying the effectiveness of key provisions. At the end
of 2017, Congress repealed part of the ACA that required most individuals to purchase and maintain health insurance. If the ACA is repealed or further substantially modified, or if implementation of certain aspects of the ACA are diluted or delayed,
such repeal, modification or delay may impact our business, financial condition, results of operations, cash flows and the trading price of our securities.&nbsp;We are unable to predict the impact of any repeal, modification or delay in the
implementation of the ACA, including the repeal of the individual mandate, on us at this time. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In addition to the potential
impacts to the ACA under the current Administration, there could be more sweeping changes to GHC Programs, such as a change in the structure of Medicaid by converting it into a block grant or instituting &#147;per capita caps,&#148; which could
eliminate the guarantee that everyone who is eligible and applies for benefits would receive them and could potentially give states sweeping new authority to restrict eligibility, cut benefits and make it more difficult for people to enroll.
Additionally, several states are considering and pursuing changes to their Medicaid programs, such as requiring recipients to engage in employment activities as a condition of eligibility for most adults, disenrolling recipients for failure to pay a
premium, or adjusting premium amounts based on income. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The ACA and the Medicare Access and CHIP Reauthorization Act of 2015
(&#147;MACRA&#148;) also contain numerous other measures that could also affect us, including, for example, requirements that physicians participate in quality measurement programs that differentiate payments to physicians under Medicare based on
quality and cost of care, among other things, or in alternative payment models that bundle payments for episodes of care and share savings based upon established quality of care standards. MACRA also remains subject to review and potential
modification by Congress. CMS also has developed a number of voluntary and mandatory demonstration programs that shift payment risk to providers. We will continue to evaluate the impact of the voluntary and mandatory demonstration and shared savings
programs on our business and operations. </FONT></P>
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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">As a result, we ultimately cannot predict with any assurance the ultimate effect of these
laws and resulting changes to payments under GHC Programs, nor can we provide any assurance that they will not have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our
securities. Further, any fiscal tightening impacting GHC Programs or changes to the structure of any GHC Programs could have a material adverse effect on our financial condition, results of operations, cash flows and the trading price of our
securities. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Expanding eligibility of government-sponsored programs could adversely affect our reimbursement. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In January 2018, Congress reauthorized the Children&#146;s Health Insurance Program (&#147;CHIP&#148;) through 2023 and then in February
2018 lengthened this funding extension through 2027. Changes to CHIP or the ACA&#146;s expansion of Medicaid coverage could cause patients who otherwise would have participated in private healthcare insurance programs to participate in GHC Programs,
or vice versa, or cause patients who otherwise would have been covered by CHIP or Medicaid to lose insurance coverage altogether. Additional reform efforts, as well as amendment or repeal of the ACA, could change the eligibility requirements for
Medicaid and for other GHC Programs, including CHIP, and could increase the number of patients who participate in such programs or the number of uninsured patients. Payments received from government-sponsored programs are substantially less than
payments received from private healthcare insurance programs (managed care and other third-party payors). A shift in the mix of our payors from private healthcare insurance programs to government payors may result in an increase in our estimated
provision for contractual adjustments and uncollectibles and a corresponding decrease in our net revenue, as well as a significant reduction in our average reimbursement rates. Additionally, if Congress does not act to extend CHIP beyond 2027, or if
Congress extends CHIP but substantially alters the current program, we could be adversely affected if children in states where we do business lose Medicaid coverage or payments for services furnished to these children are delayed or reduced.
</FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Government-funded programs, private insurers or state laws and regulations may limit, reduce or make retroactive adjustments to
reimbursement amounts or rates. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">A significant portion of our net revenue is derived from payments made by GHC Programs,
principally Medicare and Medicaid. These government-funded programs, as well as private insurers, have taken and may continue to take steps, including a movement toward increased use of managed care organizations, value-based purchasing, and new
patient care models to control the cost, eligibility for, use and delivery of healthcare services as a result of budgetary constraints and cost containment pressures due to unfavorable economic conditions, rising healthcare costs and for other
reasons, including those described above under Item 1. Business&#151;&#147;Government Regulation&#151;Government Reimbursement Requirements.&#148; These government-funded programs and private insurers may attempt other measures to control costs,
including bundling of services and denial of, or reduction in, reimbursement for certain services and treatments. In addition, increased consolidation among private insurers is resulting in fewer and larger third-party payors with increased
negotiating power. As a result, payments from government programs or private payors may decrease significantly. Also, any adjustment in Medicare reimbursement rates may have a detrimental impact on our reimbursement rates not only for Medicare
patients, but also for patients covered under Medicaid and other third-party payors, because a state&#146;s Medicaid payments cannot exceed the payments it would have made had those patients been enrolled in traditional Medicare, and other
third-party payors often base their reimbursement rates on a percentage of Medicare rates. Our business may also be materially affected by limitations on, or reductions in, reimbursement amounts or rates or elimination of coverage for certain
individuals or treatments. Moreover, because government-funded programs generally provide for reimbursements on a <FONT STYLE="white-space:nowrap">fee-schedule</FONT> basis rather than on a charge-related basis, we generally cannot increase our
revenue from these programs through increases in the amount we charge for our services. To the extent our costs increase, we may not be able to recover our increased costs from these programs, and cost containment measures and market changes in <FONT
STYLE="white-space:nowrap">non-government-funded</FONT> insurance plans have generally restricted our ability to recover, or shift to <FONT STYLE="white-space:nowrap">non-governmental</FONT> payors, these increased costs. In addition, funds we
receive from third-party payors are subject to audit with respect to the proper billing for physician and ancillary services and, accordingly, our revenue from these programs may be adjusted retroactively. Any retroactive adjustments to
</FONT></P>
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our reimbursement amounts could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In addition, our agreements with certain third-party payors may be terminated for various reasons, requiring us to seek reimbursement as
an <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-network</FONT></FONT> provider. In the event we attempt to balance-bill patients, we may be limited in our ability to do so by certain state laws and regulations. As these
laws and regulations continue to develop in certain states, it could incentivize certain third-party payors to terminate agreements as a business strategy which could lower overall reimbursement to providers. Any reductions in reimbursement amounts
could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Medicare pays for most physician services based upon a national service-specific fee schedule. In 2015, Congress enacted the MACRA legislation under which physicians must choose to participate in one of
two payment formulas, Merit-Based Incentive Payment System (&#147;MIPS&#148;) or Alternative Payment Models (&#147;APMs&#148;). Beginning in 2019, MIPS will allow eligible physicians to receive incentive payments from Medicare based on the
achievement of certain quality and cost metrics, among other measures, and be reduced for those who are underperforming against those same metrics and measures. As an alternative, physicians can choose to participate in an Advanced APM. Advanced
APMs are exempt from the MIPS requirements, and physicians who are meaningful participants in APMs will receive bonus payments from Medicare pursuant to the law. We will continue to operationalize the provisions of MACRA and assess any further
changes to the law or additional regulations enacted pursuant to the law. At this time we cannot predict the ultimate effect that these changes will have on us, nor can we provide any assurance that these changes will not have a material adverse
effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>We may become
subject to billing investigations by federal and state government authorities and private insurers. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Federal and state
laws, rules and regulations impose substantial penalties, including criminal and civil fines, monetary penalties, exclusion from participation in government healthcare programs and imprisonment, on entities or individuals (including any individual
corporate officers or physicians deemed responsible) that fraudulently or wrongfully bill government-funded programs or other third-party payors for healthcare services. CMS requires states to maintain a Medicaid Recovery Audit Contractor
(&#147;RAC&#148;) program. States are required to contract with one or more eligible Medicaid RACs to review Medicaid claims for any overpayments or underpayments, and to recoup overpayments from providers on behalf of the state. In addition,
federal laws, along with a growing number of state laws, allow a private person to bring a civil action in the name of the government for false billing violations. See Item 1. Business&#151; &#147;Government Regulation&#151;Fraud and Abuse
Provisions.&#148; Moreover, the current Administration has expressed a desire to increase scrutiny of providers and payments for services to further minimize fraud and abuse of the program. In addition, our contracts with private insurers often
provide such insurers with audit rights over payments made to us and the ability to seek recoupment for perceived overpayments. We believe that audits, inquiries and investigations from government agencies and private insurers will occur from time
to time in the ordinary course of our business, which could result in substantial costs to us and a diversion of management&#146;s time and attention. New regulations and heightened enforcement activity also could materially affect our cost of doing
business and our risk of becoming the subject of an audit or investigation. We cannot predict whether any future audits, inquiries or investigations, or the public disclosure of such matters, likely would have a material adverse effect on our
business, financial condition, results of operations, cash flows and the trading price of our securities. See Item 1. Business&#151;&#147;Government Investigations.&#148; </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>The healthcare industry is highly regulated, and government authorities may determine that we have failed to comply with applicable laws, rules or regulations. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The healthcare industry and physicians&#146; medical practices, including the healthcare and other services that we and our affiliated
physicians provide, are subject to extensive and complex federal, state and local laws, rules </FONT></P>
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and regulations, compliance with which imposes substantial costs on us. Of particular importance are the provisions summarized as follows: </FONT></P>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
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<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">federal laws (including the federal FCA) that prohibit entities and individuals from knowingly or recklessly making claims to Medicare, Medicaid and
other government-funded programs that contain false or fraudulent information or from improperly retaining known overpayments; </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
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<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">a provision of the Social Security Act, commonly referred to as the &#147;anti-kickback&#148; statute, that prohibits the knowing and willful offer,
payment, solicitation or receipt of any bribe, kickback, rebate or other remuneration, in cash or in kind, in return for the referral or recommendation of patients for items and services covered, in whole or in part, by federal healthcare programs,
such as Medicare and Medicaid; </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">a provision of the Social Security Act, commonly referred to as the Stark Law, that, subject to certain exceptions, prohibits physicians from referring
Medicare patients to an entity for the provision of certain &#147;designated health services&#148; if the physician or a member of such physician&#146;s family has a direct or indirect financial relationship (including a compensation arrangement)
with the entity; </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">similar state law provisions pertaining to anti-kickback, fee splitting, self-referral and false claims, which typically are not limited to
relationships involving government-funded programs; </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
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<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">provisions of HIPAA that prohibit knowingly and willfully executing a scheme or artifice to defraud a healthcare benefit program or falsifying,
concealing or covering up a material fact or making any material false, fictitious or fraudulent statement in connection with the delivery of or payment for healthcare benefits, items or services; </FONT></P></TD></TR></TABLE>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">federal and state laws related to confidentiality, privacy and security of personal information, including medical information and records, that limit
the manner in which we may use and disclose that information, impose obligations to safeguard that information and require that we notify third parties in the event of a breach; </FONT></P></TD></TR></TABLE>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">state laws that prohibit general business corporations from practicing medicine, controlling physicians&#146; medical decisions or engaging in certain
practices, such as splitting fees with physicians; </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TR style = "page-break-inside:avoid">
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<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">federal and state laws governing participation in GHC Programs could result in denial of our application to become a participating provider or
revocation of our participation or billing privileges, which in turn, could cause us to not be able to treat patients covered by the applicable program or prohibit us from billing for the treatment services provided to such patients;
</FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">federal and state laws that prohibit providers from billing and receiving payment from Medicare and Medicaid for services unless the services are
medically necessary, adequately and accurately documented and billed using codes that accurately reflect the type and level of services rendered; </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">federal and state laws pertaining to the provision of services by <FONT STYLE="white-space:nowrap">non-physician</FONT> practitioners, such as advanced
nurse practitioners, physician assistants and other clinical professionals, physician supervision of such services and reimbursement requirements that may be dependent on the manner in which the services are provided and documented; and
</FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TR style = "page-break-inside:avoid">
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<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">federal laws that impose civil administrative sanctions for, among other violations, inappropriate billing of services to federally funded healthcare
programs, inappropriately reducing hospital inpatient lengths of stay for such patients, or employing individuals who are excluded from participation in federally funded healthcare programs. </FONT></P></TD></TR></TABLE>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In addition, we believe that our business will continue to be subject to increasing regulation, the scope and effect of which we cannot
predict. See Item 1. Business&#151;&#147;Government Regulation.&#148; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We may in the future become the subject of regulatory
or other investigations, audits or proceedings, and our interpretations of applicable laws, rules and regulations may be challenged. For example, regulatory </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">32 </FONT></P>



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authorities or other parties may assert that our arrangements with our affiliated professional contractors constitute fee splitting or the corporate practice of medicine and seek to invalidate
these arrangements, which could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. See Item 1. Business&#151;&#147;Government Regulation&#151;Fee Splitting;
Corporate Practice of Medicine.&#148; Regulatory authorities or other parties also could assert that our relationships, including fee arrangements, among our affiliated professional contractors, hospital clients or referring physicians violate the
anti-kickback, fee splitting or self-referral laws and regulations or that we have submitted false claims or otherwise failed to comply with government program reimbursement requirements. See Item 1. Business&#151;&#147;Government
Regulation&#151;Fraud and Abuse Provisions&#148; and &#147;&#151;Government Reimbursement Requirements.&#148; Such investigations, proceedings and challenges could result in substantial defense costs to us and a diversion of management&#146;s time
and attention. In addition, violations of these laws are punishable by monetary fines, civil and criminal penalties, exclusion from participation in GHC Programs, and forfeiture of amounts collected in violation of such laws and regulations, any of
which could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Federal and state laws that protect the privacy and security of personal information may increase our costs and limit our ability to collect and use that information and subject us to liability if we
are unable to fully comply with such laws. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Numerous federal and state laws, rules and regulations govern the collection,
dissemination, use, security and confidentiality of personal information, including individually identifiable health information. These laws include: </FONT></P> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">Provisions of HIPAA that limit how covered entities and business associates may use and disclose PHI, provide certain rights to individuals with
respect to that information and impose certain security requirements; </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
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<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">HITECH, which strengthens and expands the HIPAA Privacy Rule and Security Rule and imposes data breach notification obligations;
</FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">Other federal and state laws restricting the use and protecting the privacy and security of personal information, including health information, many of
which are not preempted by HIPAA; </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">Federal and state consumer protection laws; and </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">Federal and state laws regulating the conduct of research with human subjects. </FONT></P></TD></TR></TABLE>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">As part of our business operations, including our medical record keeping, third-party billing, research and other services, we collect
and maintain PHI in paper and electronic format. Standards related to health information, whether implemented pursuant to HIPAA, HITECH, state laws, federal or state action or otherwise, could have a significant effect on the manner in which we
handle personal information, including <FONT STYLE="white-space:nowrap">healthcare-related</FONT> data, and communicate with payors, providers, patients and others, and compliance with these standards could impose significant costs on us or limit
our ability to offer services, thereby negatively impacting the business opportunities available to us. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">If we are alleged to
not comply with existing or new laws, rules and regulations related to PHI we could be subject to litigation and to sanctions that include monetary fines, civil or administrative penalties, civil damage awards or criminal penalties. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Government authorities or other parties may assert that our business practices violate antitrust laws. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The healthcare industry is subject to close antitrust scrutiny. The FTC, the Antitrust Division of the DOJ and state Attorneys General all
actively review and, in some cases, take enforcement action against business conduct and acquisitions in the healthcare industry. Private parties harmed by alleged anticompetitive conduct can also
</FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">33 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
bring antitrust suits. Violations of antitrust laws may be punishable by substantial penalties, including significant monetary fines, civil penalties, criminal sanctions, and consent decrees and
injunctions prohibiting certain activities or requiring divestiture or discontinuance of business operations. Any of these penalties could have a material adverse effect on our business, financial condition, results of operations, cash flows and the
trading price of our securities. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Our affiliated physicians and third-party contractors may not appropriately record or document services
that they provide. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our affiliated physicians are responsible for appropriately recording and documenting the services that
they provide. We use this information to seek reimbursement for their services from third-party payors. In addition, we utilize third-party contractors to perform certain revenue cycle management functions for healthcare providers, including medical
coding. If our physicians and third-party contractors do not appropriately document, or where applicable, code for their services or our customers&#146; services, we could be subjected to administrative, regulatory, civil, or criminal investigations
or sanctions and our business, financial condition, results of operations and cash flows could be materially adversely affected. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Failure
to manage third-party service providers may adversely affect our ability to maintain the quality of service that we provide. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We outsource a certain portion of our revenue cycle management functions to third-party service providers, but we may increase the amount
of revenue cycle management functions we outsource in the future. These functions are performed both domestically and in offshore locations, with our oversight. If our outsourcing partners fail to perform their obligations in a timely manner or at
satisfactory quality levels or if they are unable to attract or retain sufficient personnel with the necessary skill sets to meet our outsourcing needs, the efficiency, effectiveness and quality of our services could suffer. In addition, our
reliance on a workforce in other countries exposes us to disruptions in the business, political and economic environment in those regions. Further, any changes to existing laws or the enactment of new legislation restricting offshore outsourcing in
the United States may adversely affect our ability to outsource functions to third-party offshore service providers. Our ability to manage any difficulties encountered could be largely outside of our control. In addition, payors may have
prohibitions or restrictions on the use of third-party service providers and/or require notice for the use of such third-party service providers. Diminished service quality from outsourcing, our inability to utilize offshore service providers or the
failure to know about restrictions on the use of third-party service providers could have an adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>We may not find suitable acquisition candidates or successfully integrate our acquisitions. Our acquisitions may expose us to greater business risks
and could affect our payor mix. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We have expanded and continue to seek to expand our presence in new and existing
metropolitan areas by acquiring established neonatal, radiology, anesthesia, maternal-fetal, pediatric cardiology and other complementary pediatric subspecialty physician group practices as well teleradiology services companies. Also, both
independently and in collaboration with our hospital partners, we may seek to expand into other specialties and subspecialties. In addition, we have acquired physician and other healthcare services companies that are complementary to our physician
practices. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our acquisition strategy involves numerous risks and uncertainties, including: </FONT></P>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">We may not be able to identify suitable acquisition candidates or strategic opportunities or implement successfully or realize the expected benefits of
any suitable opportunities. In addition, we compete for acquisitions with other potential acquirers, some of which may have greater financial or operational resources than we do. This competition may intensify due to the ongoing consolidation in the
healthcare industry, which may increase our acquisition costs. </FONT></P></TD></TR></TABLE>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">34 </FONT></P>



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<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">We may not be able to complete acquisitions of physician practices or services companies or we may complete acquisitions on less favorable terms as a
result of changes in tax laws, financial market or other economic or market conditions. </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">We may not be able to successfully integrate completed acquisitions, including our recent acquisitions. Integrating completed acquisitions into our
existing operations involves numerous short-term and long-term risks, including diversion of our management&#146;s attention, failure to retain key personnel, long-term value of acquired intangible assets and acquisition expenses. In addition, we
may be required to comply with laws, rules and regulations that may differ not only from those of the states in which our operations are currently conducted but from an expansion in the service offerings we provide in certain states for which the
laws, rules and regulations may be different. </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">We cannot be certain that any acquired business will continue to maintain its <FONT STYLE="white-space:nowrap">pre-acquisition</FONT> revenue and
growth rates or be financially successful. In addition, we cannot be certain of the extent of any unknown or contingent liabilities of any acquired business, including liabilities for failure to comply with applicable laws, or liabilities relating
to medical malpractice claims. Generally we obtain indemnification agreements from the sellers of businesses acquired with respect to <FONT STYLE="white-space:nowrap">pre-closing</FONT> acts, omissions and other similar risks. It is possible that we
may seek to enforce indemnification provisions in the future against sellers who may no longer have the financial wherewithal to satisfy their obligations to us. Accordingly, we may incur material liabilities for past activities of acquired
businesses. </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">We could incur or assume indebtedness and issue equity in connection with acquisitions. The issuance of shares of our common stock for an acquisition
may result in dilution to our existing shareholders and, depending on the number of shares that we issue, the resale of such shares could affect the trading price of our common stock. </FONT></P></TD></TR></TABLE>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">We may acquire businesses that derive a greater portion of their revenue from GHC Programs than what we recognize on a consolidated basis or that have
business models with lower operating margins than ours. These acquisitions could affect our overall payor mix or operating results in future periods. </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">Acquisitions of practices and services companies could entail financial and operating risks not fully anticipated. Such acquisitions could divert
management&#146;s attention and our resources. </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">An acquisition could be subject to a challenge under the antitrust laws either before or after it is consummated. Such a challenge could involve
substantial legal costs and divert management&#146;s attention and resources and could result in us having to abandon the transaction or make a divestiture. </FONT></P></TD></TR></TABLE> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>We may not be able to successfully execute our same-unit and organic growth strategies. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">In addition to our acquisition growth strategy, we seek opportunities for increasing revenue from our existing operations through same-unit and organic growth strategies. We also seek opportunities to
grow organically outside of our existing operations. We may not be able to successfully execute our same-unit and organic growth strategies for reasons including the following: </FONT></P>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">We may not be able to expand the services that our affiliated physicians provide to our hospital partners or the services provided by our services
companies to their customers. </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">We may not be able to attract referrals to our office-based practices or neonatology transports to our hospital-based units.
</FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">We may not be able to execute new contractual arrangements with hospitals, including through joint ventures, where we either currently provide or do
not currently provide physician services. </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">We may not be able to work with our hospital partners to develop integrated services programs for which we become a multi-specialty provider of
solutions within the maternal-fetal, newborn, pediatric continuum of care. </FONT></P></TD></TR></TABLE>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">35 </FONT></P>



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<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#149;</FONT></TD>
<TD WIDTH="1%" VALIGN="top"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">We may not accurately project same-unit and organic growth performance, or we may experience a shift in the mix of services that certain of our
customers request from us, potentially resulting in lower margins. </FONT></P></TD></TR></TABLE> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In addition, certain of our organic
growth strategies may involve risks and uncertainties similar to those for our acquisition strategy. See &#147;We may not find suitable acquisition candidates or successfully integrate our acquisitions. Our acquisitions may expose us to greater
business risks and could affect our payor mix.&#148; </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>We may not be able to maintain effective and efficient information systems or
properly safeguard our information systems. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our operations are dependent on uninterrupted performance of our information
systems. Failure to maintain reliable information systems, disruptions in our existing information systems or the implementation of new systems could cause disruptions in our business operations, including errors and delays in billings and
collections, difficulty satisfying requirements under hospital contracts, disputes with patients and payors, violations of patient privacy and confidentiality requirements and other regulatory requirements, increased administrative expenses and
other adverse consequences. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In addition, information security risks have generally increased in recent years because of new
technologies and the increased activities of perpetrators of cyber-attacks resulting in the theft of protected health, business or financial information. Despite our layered security controls, experienced computer programmers and hackers may be able
to penetrate our information systems and misappropriate or compromise sensitive patient or personnel information or proprietary or confidential information, create system disruptions or cause shutdowns. They also may be able to develop and deploy
viruses, worms and other malicious software programs that disable our systems or otherwise exploit any security vulnerabilities. Outside parties may also attempt to fraudulently induce employees to take actions, including the release of confidential
or sensitive information or to make fraudulent payments, through illegal electronic spamming, phishing or other tactics. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">A
failure in or breach of our information systems as a result of cyber-attacks or other tactics could disrupt our business, result in the release or misuse of PHI, confidential or proprietary business information or cause financial loss, damage our
reputation, increase our administrative expenses, and expose us to additional risk of liability to federal or state governments or individuals. Although we believe that we have robust information security procedures and other safeguards in place,
which are monitored and routinely tested internally and by external parties, as cyber threats continue to evolve, we may be required to expend additional resources to continue to enhance our information security measures or to investigate and
remediate any information security vulnerabilities. Our remediation efforts may not be successful and could result in interruptions, delays or cessation of service and loss of existing or potential customers and disruption of our operations,
including, without limitation, our billing processes. In addition, breaches of our security measures and the unauthorized dissemination of patient healthcare and other sensitive information, proprietary or confidential information about us, our
patients, clients or customers, or other third-parties, could expose such persons&#146; private information to the risk of financial or medical identity theft or expose us or such persons to a risk of loss or misuse of this information, result in
litigation and potential liability for us, damage our brand and reputation or otherwise harm our business. Additionally, under certain circumstances, we could be excluded temporarily or permanently from certain commercial or GHC Programs. Any of
these disruptions or breaches of security could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Our employees and business partners may not appropriately secure and protect confidential information in their possession. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Each of our employees and business partners is responsible for the security of the information in our systems or under our control and to ensure that private and financial information is kept
confidential. Should an </FONT></P>
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employee or business partner not follow appropriate security measures, including those related to cyber threats or attacks or other tactics, as well as our privacy and security policies and
procedures, the improper release of personal information, including PHI, or confidential business or financial information, or misappropriation of assets could result. The release of such information or misappropriation of assets could have a
material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>We may not be able to successfully recruit, onboard and retain qualified physicians and other clinicians and our compensation expense for existing
clinicians may increase. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We are dependent upon our ability to recruit and retain a sufficient number of qualified
physicians and other clinicians to service existing units at hospitals and our affiliated practices, service our existing customers&#146; radiology read volumes and expand our business. We compete with many types of healthcare providers, including
teaching, research and government institutions, hospitals and health systems and other practice and services groups, for the services of qualified clinicians. We may not be able to continue to recruit new clinicians or renew contracts with existing
clinicians on acceptable terms. In addition, the recruiting and onboarding process for certain of our physicians and other clinicians can take several months, or longer, to complete due to various requirements, including state licensing and hospital
credentialing. In addition, if the demand exceeds the supply for physicians and other clinicians either in general or in specific markets, we could experience an increase in compensation expense, including premium pay and agency labor costs. If we
are unable to recruit new physicians, renew contracts on acceptable terms or onboard physicians and clinicians in a reasonable period of time, our ability to service existing or new hospital units, staff existing or new office-based practices and
service our existing or new customer radiology read volumes could be adversely affected. In addition, if we experience a higher rate of growth in clinician compensation expense, our business, financial condition, results of operations, cash flows
and the trading price of our securities could be materially, adversely affected. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>A significant number of our affiliated physicians or
other clinicians could leave our affiliated practices or our affiliated professional contractors may be unable to enforce the <FONT STYLE="white-space:nowrap">non-competition</FONT> covenants of departed physicians. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our affiliated professional contractors usually enter into employment agreements with our affiliated physicians. Certain of our employment
agreements can be terminated without cause by any party upon prior written notice. In addition, substantially all of our affiliated physicians have agreed not to compete within a specified geographic area for a certain period after termination of
employment. The law governing <FONT STYLE="white-space:nowrap">non-compete</FONT> agreements and other forms of restrictive covenants varies from state to state. Although we believe that the <FONT STYLE="white-space:nowrap">non-competition</FONT>
and other restrictive covenants applicable to our affiliated physicians are reasonable in scope and duration and therefore enforceable under applicable state law, courts and arbitrators in some states may be reluctant to enforce <FONT
STYLE="white-space:nowrap">non-compete</FONT> agreements and restrictive covenants against physicians. In addition, we may incur significant legal fees to pursue enforcement of such agreements and restrictive covenants. Our affiliated physicians or
other clinicians may leave our affiliated practices for a variety of reasons, including in order to provide services for other types of healthcare providers, such as teaching, research and government institutions, hospitals and health systems and
other practice groups. If a substantial number of our affiliated physicians or other clinicians leave our affiliated practices, we could incur significant legal fees to pursue enforcement of certain covenants within employment agreements or if our
affiliated professional contractors are unable to enforce the <FONT STYLE="white-space:nowrap">non-competition</FONT> covenants in the employment agreements, our business, financial condition, results of operations and cash flows could be
materially, adversely affected. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Our treatment of certain physicians and other clinicians as independent contractors may be challenged by
taxing authorities or other governmental agencies. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Certain of our affiliated physicians and other clinicians are treated
as independent contractors, as opposed to employees, and, accordingly, we do not withhold federal income, state income, FICA, or other employment </FONT></P>
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related taxes from these individuals&#146; compensation, make federal income, state income, FICA, or unemployment tax or other related payments, provide workers&#146; compensation insurance
or&nbsp;allow them to participate in the benefits and retirement programs available to our employees, or apply federal or state employee requirements. The classification of physicians and other clinicians as independent contractors depends on the
facts and circumstances of the relationship. Additionally, under current federal tax law, a safe harbor from reclassification, and consequently retroactive taxes and penalties, is available if our current treatment is consistent with a long-standing
practice of a significant segment of our industry and if we meet certain other requirements. In the past, there have been proposals to eliminate the safe harbor, and similar proposals may happen again in the future. If taxing authorities or other
governmental agencies are successful in challenging our treatment of these physicians and other clinicians as independent contractors, and we do not prevail in demonstrating the applicability of the safe harbor to our operations or the safe harbor
is eliminated, we may be required to pay retroactive employment taxes and penalties and reclassify such independent contractors to employees. In addition, such independent contractors could claim retroactive entitlements to various employee
benefits. Any of these actions would increase our costs related to these physicians and our business, financial condition, results of operations and cash flows could be materially, adversely affected. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>We may be subject to medical malpractice and other lawsuits not covered by insurance. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our business entails an inherent risk of claims of medical malpractice against our affiliated physicians and us. We may also be subject to
other lawsuits which may involve large claims and significant defense costs. Although we currently maintain liability insurance coverage intended to cover professional liability and other claims, there can be no assurance that our insurance coverage
will be adequate to cover liabilities arising out of claims asserted against us where the outcomes of such claims are unfavorable to us. Generally, we self-insure our liabilities to pay retention amounts for professional liability matters through a
wholly owned captive insurance subsidiary. Liabilities in excess of our insurance coverage, including coverage for professional liability and other claims, could have a material adverse effect on our business, financial condition, results of
operations, cash flows and the trading price of our securities. See Item 1. Business&#151;&#147;Other Legal Proceedings&#148; and&#151; &#147;Professional and General Liability Coverage.&#148; </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>The reserves that we have established related to our professional liability losses are subject to inherent uncertainties and if a deficiency is
determined this may lead to a reduction in our net earnings. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We have established reserves for losses and related expenses
that represent estimates involving actuarial projections. These actuarial projections are developed at a given point in time and represent our expectations of the ultimate resolution and administration of costs of losses incurred with respect to
professional liability risks for the amount of risk retained by us. Insurance reserves are inherently subject to uncertainty. Our reserve estimates are based on actuarial valuations using historical claims, demographic factors, industry trends,
severity and exposure factors and other actuarial assumptions. The estimates of projected ultimate losses are developed at least annually. Our reserves could be significantly affected should current and future occurrences differ from historical
claim trends and expectations. While claims are monitored closely when estimating reserves, the complexity of the claims and wide range of potential outcomes often hamper timely adjustments to the assumptions used in these estimates. Actual losses
and related expenses may deviate, perhaps substantially, from the reserve estimates reflected in our financial statements. If our estimated reserves are determined to be inadequate, we will be required to increase reserves at the time the deficiency
is determined. See Item 7. Management&#146;s Discussion and Analysis of Financial Condition and Results of Operations&#151;&#147;Application of Critical Accounting Policies and Estimates&#151;Professional Liability Coverage.&#148; </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>We may <FONT STYLE="white-space:nowrap">write-off</FONT> intangible assets, such as goodwill. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The carrying value of our intangible assets, which consists primarily of goodwill related to our acquisitions, is subject to testing at
least annually, and more frequently if impairment indicators exist. Under current accounting standards, goodwill is tested for impairment on an annual basis and we may be subject to impairment
</FONT></P>
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losses as circumstances change after an acquisition. If we record an impairment loss related to our goodwill, it could have a material adverse effect on our business, financial condition, results
of operations, cash flows and the trading price of our securities. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>We may not effectively manage our growth. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We have experienced significant growth in our business, including growth outside of our core physician specialties of neonatology and
anesthesiology. Growth in the number of our employees and affiliated physicians in recent years places significant demands on our financial, operational and management resources. Continued growth may impair our ability to provide our services
efficiently and to manage our employees adequately. While we are taking steps to manage our growth, our future results of operations could be materially, adversely affected if we are unable to do so effectively. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Our quarterly results will likely fluctuate from period to period. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">We have historically experienced and expect to continue to experience quarterly fluctuations in net revenue and net income. For example, we typically experience negative cash flow from operations in the
first quarter of each year, principally as a result of bonus payments to affiliated physicians as well as discretionary matching contributions for participants in our qualified contributory savings plans. In addition, a significant number of our
employees and associated professional contractors (primarily affiliated physicians) exceed the level of taxable wages for social security contributions during the first and second quarters. As a result, we incur a significantly higher payroll tax
burden and our net income is lower during those quarters. Moreover, a lower number of calendar days are present in the first and second quarters of the year as compared to the remainder of the year. Because we provide services in the NICU on a <FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">24-hours-a-day</FONT></FONT></FONT> basis, 365 days a year, any reduction in service days will have a corresponding reduction in net revenue. In addition,
any reduction in office days in our office-based practices or business days in our anesthesia practices will also have a corresponding reduction in net revenue. We also have significant fixed operating costs, including costs for our affiliated
physicians, and as a result, are highly dependent on patient volume and capacity utilization of our affiliated physicians to sustain profitability. Quarterly results may also be impacted by the timing of acquisitions and any fluctuation in patient
volume. As a result, our results of operations for any quarter are not indicative of results of operations for any future period or full fiscal year. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Our current indebtedness and any future indebtedness could adversely affect us by reducing our flexibility to respond to changing business and economic conditions and expose us to interest rate risk to
the extent of any variable rate debt. In addition, a certain portion of our interest expense may not be deductible. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">As of
December&nbsp;31, 2017, our total indebtedness was $1.9&nbsp;billion, of which $1.1&nbsp;billion was exposed to variable interest rates. We also had $889.3&nbsp;million of additional borrowing capacity under our revolving line of credit which was
subject to a variable interest rate. Other debt we incur also could be variable rate debt. In addition, the Tax Cuts and Jobs Act of 2017 places certain limitations on the deductibility of interest expense at a percentage of taxable income. If
interest rates increase, our variable rate debt will create higher debt service requirements, and if interest expense increases beyond a specified percentage of taxable income, a portion of that interest expense may not be deductible for income tax
purposes, which could adversely affect our results of operations and cash flows. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We have limited restrictions on incurring
substantial additional indebtedness in the future. Our current indebtedness and any future increases in leverage could have adverse consequences on us, including: </FONT></P> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">a substantial portion of our cash flow from operations will be required to service interest and principal payments on our debt and will not be
available for operations, working capital, capital expenditures, expansion, acquisitions, dividends or general corporate or other purposes; </FONT></P></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">our ability to obtain additional financing in the future may be impaired; </FONT></P></TD></TR></TABLE>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">we may be more highly leveraged than our competitors, which may place us at a competitive disadvantage; </FONT></P></TD></TR></TABLE>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">our flexibility in planning for, or reacting to, changes in our business and industry may be limited; and </FONT></P></TD></TR></TABLE>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TD ALIGN="left" VALIGN="top"> <P ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">we may be more vulnerable in the event of a downturn in our business, our industry or the economy in general. </FONT></P></TD></TR></TABLE>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our ability to make payments on and to refinance our debt will depend on our ability to generate cash in the future. This, to a certain
extent, is subject to general economic, business, financial, competitive, legislative, regulatory, and other factors that are beyond our control. We cannot assure you that our business will generate sufficient cash flow from operations or that
future borrowings will be available under our revolving line of credit in an amount sufficient to enable us to pay our debt or to fund our other liquidity needs. We may need to refinance all or a portion of our debt on or before maturity. We cannot
assure you that we will be able to refinance any of our debt, including our revolving line of credit and senior notes, on commercially reasonable terms or at all. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Servicing our debt requires a significant amount of cash. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our ability to
make scheduled payments on or to refinance our debt obligations depends on our financial condition and operating performance, which is subject to prevailing economic and competitive conditions and to certain financial, business, and other factors.
We may not be able to maintain a level of cash flows from operating activities sufficient to permit us to pay the principal and interest on our indebtedness. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">If our cash flows and capital resources are insufficient to fund our debt service requirements, we may be forced to reduce or delay acquisitions or other investments, or to seek additional capital, or
restructure or refinance our indebtedness. Our ability to restructure or refinance our debt will depend on the condition of the capital markets and our financial condition at such time. In addition, any failure to make payments of interest and
principal on our outstanding indebtedness on a timely basis would likely result in other defaults, disrupt our operations and cause a reduction of our credit rating, which could further harm our ability to finance or refinance our obligations and
business operations. These alternative measures may not be successful and may not permit us to meet our scheduled debt service obligations. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>The value of our common stock may fluctuate. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">There has been significant volatility in the market price of securities of healthcare companies generally that we believe in many cases has been unrelated to operating performance. In addition, we believe
that certain factors, such as actual and potential legislative and regulatory developments, including announced regulatory investigations, quarterly fluctuations in our actual or anticipated results of operations, lower revenue or earnings than
those anticipated by securities analysts, not meeting publicly announced expectations, and general economic and financial market conditions, could cause the price of our common stock to fluctuate substantially. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>We may not be able to collect reimbursements for our services from third-party payors. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">A significant portion of our net revenue is derived from reimbursements from various third-party payors, including GHC Programs, private
insurance plans and managed care plans, for services provided by our affiliated professional contractors. We are responsible for submitting reimbursement requests to these payors and collecting the reimbursements, and we assume the financial risks
relating to uncollectible and delayed reimbursements. In the current healthcare environment, payors continue their efforts to control expenditures for healthcare, including revisions to coverage and reimbursement policies. Due to the nature of our
business and our participation in government-funded and private reimbursement programs, we are involved from time to time in inquiries, reviews, audits and investigations by governmental agencies and private payors of our business practices,
including assessments of our compliance with coding, billing and documentation requirements. We </FONT></P>
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may be required to repay these agencies or private payors if a finding is made that we were incorrectly reimbursed, or we may become involved in disputes with payors and could be subjected to <FONT
STYLE="white-space:nowrap">pre-payment</FONT> and post-payment reviews, which can be time-consuming and result in <FONT STYLE="white-space:nowrap">non-payment</FONT> or delayed payment for the services we provide. We may also experience difficulties
in collecting reimbursements because third-party payors may seek to reduce or delay reimbursements to which we are entitled for services that our affiliated physicians have provided or they experience administrative issues that result in a delay in
reimbursements. In addition, GHC Programs may deny our application to become a participating provider that could cause us to not be able to provide services to patients or prohibit us from billing for such services. If we are not reimbursed fully
and in a timely manner for such services or there is a finding that we were incorrectly reimbursed, our revenue, cash flows and financial condition could be materially, adversely affected. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In addition, adverse economic conditions could affect the timeliness and amounts received from our third-party and government payors
which would impact our short-term liquidity needs. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Hospitals or other customers may terminate their agreements with us, our physicians may
lose the ability to provide services in hospitals or administrative fees paid to us by hospitals may be reduced. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our net
revenue is derived primarily from <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">fee-for-service</FONT></FONT> billings for patient care and other services provided by our affiliated physicians and from administrative fees paid to
us by hospitals. See Item 1. Business&#151;&#147;Relationships with Our Partners&#151;Hospitals.&#148; Our hospital partners or other customers may cancel or not renew their contracts with us, may reduce or eliminate our administrative fees in the
future, or refuse to pay us our administrative fees if we fail to honor the terms of our agreement or fail to meet certain performance metrics under those agreements. Further, consolidation of hospitals, health care systems or other customers could
adversely affect our ability to negotiate with these entities. Adverse economic conditions, including decreased federal and state funding to hospitals, could influence future actions of our hospital partners or other customers. To the extent that
our arrangements with our hospital partners or other customers are canceled, or are not renewed or replaced with other arrangements having at least as favorable terms, our business, financial condition and results of operations could be adversely
affected. In addition, to the extent our affiliated physicians lose their privileges in hospitals or hospitals enter into arrangements with or employ other physicians, including our existing affiliated physicians, our business, financial condition,
results of operations and cash flows could be materially, adversely affected. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Hospitals could limit our ability to use our management
information systems in our units by requiring us to use their own management information systems. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%;padding-bottom:0px; "><FONT STYLE="font-family:Times New Roman" SIZE="2">Our
management information systems, including BabySteps<FONT STYLE="font-family:Times New Roman" SIZE="1"><SUP STYLE="vertical-align:baseline; position:relative; bottom:.8ex">&reg;</SUP></FONT> and the Quantum Clinical Navigation System<FONT
STYLE="font-family:Times New Roman" SIZE="1"><SUP STYLE="vertical-align:baseline; position:relative; bottom:.8ex">&reg;</SUP></FONT> are used to support our <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">day-to-day</FONT></FONT>
operations and ongoing clinical research and business analysis. If a hospital prohibits us from using our own management information systems, it may interrupt the efficient operation of our information systems which, in turn, may limit our ability
to operate important aspects of our business, including billing and reimbursement as well as research and education initiatives. This inability to use our management information systems at hospital locations may have a material adverse effect on our
business, financial condition, results of operations and cash flows. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Our industry is already competitive and could become more
competitive. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The healthcare industry is highly competitive and subject to continual changes in the methods by which
services are provided and the manner in which healthcare providers are selected and compensated. Because our operations consist primarily of physician services provided within hospital-based units, we compete with other healthcare services companies
and physician groups for contracts with hospitals to provide our services to patients. We also face competition from hospitals themselves to provide our services. In addition, we face competition from other services companies in our teleradiology
business and management services organization. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">41 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Further, consolidation within the healthcare industry could strengthen certain competitors
that provide services to hospitals and other customers. Companies in other healthcare industry segments, some of which have greater financial and other resources than ours, may become competitors in providing neonatal, anesthesia, maternal-fetal,
radiology or other pediatric subspecialty care. Additionally, we face competition from healthcare-focused and other private equity firms. We may not be able to continue to compete effectively in this industry, additional competitors may enter
metropolitan areas where we operate, and this increased competition may have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Unfavorable changes or conditions could occur in the states where our operations are concentrated. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">A majority of our net revenue in 2017 was generated by our operations in five states. In particular, Texas accounted for approximately 19%
of our net revenue in 2017. See Item 1. Business&#151;&#147;Geographic Coverage.&#148; Adverse changes or conditions affecting these particular states, such as healthcare reforms, changes in laws and regulations, reduced Medicaid eligibility or
reimbursements and government investigations, economic conditions, weather conditions, and natural disasters may have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our
securities. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>We are dependent upon our key management personnel for our future success. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our success depends to a significant extent on the continued contributions of our key management personnel, including our Chief Executive
Officer, Roger J. Medel, M.D., for the management of our business and implementation of our business strategy. The loss of Dr.&nbsp;Medel or other key management personnel could have a material adverse effect on our business, financial condition,
results of operations, cash flows and the trading price of our securities. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>We are subject to litigation risks. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">From time to time, we are involved in various litigation matters and claims, including regulatory proceedings, administrative proceedings,
governmental investigations, and contract disputes, as they relate to our services and business. We may face potential claims or liability for, among other things, breach of contract, defamation, libel, fraud or negligence. Our contracts with
hospitals generally require us to indemnify them and their affiliates for losses resulting from the negligence of our affiliated physicians and other clinicians. We may also face employment-related litigation, including claims of age
discrimination,&nbsp;sexual harassment, gender discrimination, immigration violations, or other local, state, and federal labor law violations. Because of the uncertain nature of litigation and insurance coverage decisions, the outcome of such
actions and proceedings cannot be predicted with certainty and an unfavorable resolution of one or more of them could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our
securities. In addition, legal fees and costs associated with prosecuting and defending litigation matters could have a material adverse effect on our business, financial condition, results of operation and the trading price of our securities.
</FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Provisions of our articles and bylaws could deter takeover attempts, but our business could be negatively affected as a result of
shareholder activism. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our Amended and Restated Articles of Incorporation, as amended, authorize our board of directors to
issue up to 1,000,000 shares of undesignated preferred stock and to determine the powers, preferences and rights of these shares without shareholder approval. This preferred stock could be issued with voting, liquidation, dividend and other rights
superior to those of the holders of common stock. The issuance of preferred stock under some circumstances could have the effect of delaying, deferring or preventing a change in control. In addition, provisions in our Amended and Restated Articles
of Incorporation, as amended, and Bylaws, including those relating to calling shareholder meetings, taking action by written consent and other matters, could render it more </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">42 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
difficult or discourage an attempt to obtain control of MEDNAX through a proxy contest or consent solicitation, however, there is no assurance that these provisions would have such an effect.
These provisions could limit the price that some investors might be willing to pay in the future for our shares of common stock. Notwithstanding these provisions, we could become the target of activist shareholders who acquire ownership positions in
our common stock and seek to influence our company. Responding to actions by activist shareholders can be costly and time-consuming, disrupt our business and divert the attention of our board of directors, management and employees. Additionally,
perceived uncertainties as to our future direction as a result of shareholder activism may lead to the perception of a change in the direction of our business or other instability, which may be exploited by our competitors, cause concern to our
current or potential customers and acquisition candidates, and make it more difficult for us to attract and retain qualified personnel, which could have a material adverse effect on our business, financial condition, results of operations, and cash
flows and the trading prices of our securities. In addition, the trading prices of our securities may experience periods of increased volatility as a result of shareholder activism. </FONT></P>
<P STYLE="font-size:18px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><A NAME="tx463027_3"></A>ITEM&nbsp;1B.</B></FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>UNRESOLVED STAFF COMMENTS </B></FONT></TD></TR></TABLE>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">None. </FONT></P> <P STYLE="font-size:18px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><A NAME="tx463027_4"></A>ITEM&nbsp;2.</B></FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>PROPERTIES </B></FONT></TD></TR></TABLE> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our corporate
office building, which we own, is located in Sunrise, Florida and contains 80,000 square feet of office space. We own an additional corporate office building covering an additional 180,000 square feet in Sunrise, Florida. We also own an office
building used for our management services organization call center operations covering 175,000 square feet in Cascade Falls, Michigan. We also lease space in hospitals and other facilities for our business and medical offices, and other needs. See
Note 16 to the Consolidated Financial Statements in this Form <FONT STYLE="white-space:nowrap">10-K,</FONT> which is incorporated herein by reference. We believe that our facilities and the equipment used in our business are in good condition, in
all material respects, and sufficient for our present needs. </FONT></P> <P STYLE="font-size:18px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><A NAME="tx463027_5"></A>ITEM&nbsp;3.</B></FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>LEGAL PROCEEDINGS </B></FONT></TD></TR></TABLE> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The
information required by this Item is included in and incorporated herein by reference to Item 1. Business of this Form <FONT STYLE="white-space:nowrap">10-K</FONT> under &#147;Government Investigations&#148; and &#147;Other Legal Proceedings.&#148;
</FONT></P> <P STYLE="font-size:18px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><A NAME="tx463027_6"></A>ITEM&nbsp;4.</B></FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>MINE SAFETY DISCLOSURES </B></FONT></TD></TR></TABLE>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Not applicable </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">43 </FONT></P>



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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx463027_31"></A>PART II </B></P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="9%" VALIGN="top" ALIGN="left"><B><A NAME="tx463027_7"></A>ITEM&nbsp;5.</B></TD>
<TD ALIGN="left" VALIGN="top"><B>MARKET FOR REGISTRANT&#146;S COMMON EQUITY, RELATED STOCKHOLDER MATTERS AND ISSUER PURCHASES OF EQUITY SECURITIES </B></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Price Range of Common Stock </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our common
stock is traded on the New York Stock Exchange (the &#147;NYSE&#148;) under the symbol &#147;MD.&#148; The high and low sales prices for a share of our common stock for each quarter during our last two fiscal years are set forth below: </P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="76%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="76%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>High</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Low</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><B><U>2017</U></B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Fourth Quarter</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">54.05</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">40.56</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Third Quarter</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">60.80</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">40.78</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Second Quarter</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">69.57</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">53.80</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">First Quarter</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">72.13</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">64.05</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><B><U>2016</U></B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Fourth Quarter</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">69.68</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">59.36</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Third Quarter</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">76.96</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">62.63</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Second Quarter</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">73.68</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">61.87</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">First Quarter</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">71.26</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">61.40</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As of February&nbsp;9, 2018, we had 357 holders of record of our common stock, and the closing sales price on
that date for our common stock was $53.94 per share. We believe that the number of beneficial owners of our common stock is greater than the number of record holders because a significant number of shares of our common stock is held through
brokerage firms in &#147;street name.&#148; </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Dividend Policy </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We did not declare or pay any cash dividends on our common stock in 2017, 2016 or 2015, nor do we currently intend to declare or pay any cash
dividends in the future. The payment of any future dividends will be at the discretion of our Board of Directors and will depend upon, among other things, future earnings, results of operations, capital requirements, our general financial condition,
general business conditions and contractual restrictions on payment of dividends, if any, as well as such other factors as our Board of Directors may deem relevant. Our credit agreement imposes certain limitations on our ability to declare and pay
cash dividends. See Item 7. Management&#146;s Discussion and Analysis of Financial Condition and Results of Operations&#151;&#147;Liquidity and Capital Resources.&#148; </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">44 </P>


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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Performance Graph </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following graph compares the cumulative total shareholder return on $100 invested on December&nbsp;31, 2012 in our common stock against the
cumulative total return of the S&amp;P 500 Index, S&amp;P 600 Health Care Index, and the NYSE Composite Index. The returns are calculated assuming reinvestment of dividends. The graph covers the period from December&nbsp;31, 2012 through
December&nbsp;31, 2017, and gives effect to a <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">two-for-one</FONT></FONT> stock split effective December&nbsp;19, 2013. The stock price performance included in the graph is not
necessarily indicative of future stock price performance. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><I>The performance graph shall not be deemed incorporated by reference by any
general statement incorporating by reference this annual report into any filing under the Securities Act of 1933 or the Securities Exchange Act of 1934, except to the extent that we specifically incorporate this information by reference, and shall
not otherwise be deemed filed under such acts. </I></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P> <P STYLE="font-size:0pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<P STYLE="margin-top:0pt;margin-bottom:0pt" ALIGN="center">


<IMG SRC="g463027g94d84.jpg" ALT="LOGO">
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<TD VALIGN="bottom">&nbsp;</TD>
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<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Base&nbsp;Period</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="18" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ending</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom" NOWRAP> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-bottom:1.00pt solid #000000; width:55.10pt; display:inline; font-size:8pt; font-family:Times New Roman; "><B>Company/Index</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2012</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2013</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2014</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2015</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2017</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">MEDNAX, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">100.00</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">134.26</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">166.27</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">180.23</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">167.66</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">134.41</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">S&amp;P 500 Index</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">100.00</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">129.60</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">144.36</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">143.31</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">156.98</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">187.47</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">S&amp;P 600 Health Care</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">100.00</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">155.51</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">172.49</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">207.66</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">211.70</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">284.69</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">NYSE Composite Index</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">100.00</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">123.18</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">128.37</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">120.13</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">130.95</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">151.70</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Issuer Purchases of Equity Securities </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the three months ended December&nbsp;31, 2017, we did not repurchase any shares of our equity securities. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">45 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Recent Sales of Unregistered Equity Securities </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">During the three months ended December&nbsp;31, 2017, we did not sell any unregistered shares of our equity securities. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Equity Compensation Plans </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Information regarding equity compensation plans is set forth in Item 12 of this Form <FONT STYLE="white-space:nowrap">10-K</FONT> and is
incorporated herein by reference. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">46 </FONT></P>



<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>



<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><A NAME="tx463027_8"></A>ITEM&nbsp;6.</B></FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>SELECTED FINANCIAL DATA </B></FONT></TD></TR></TABLE>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The following table includes selected consolidated financial data set forth as of and for each of the five years in the period ended
December&nbsp;31, 2017. All share and per share amounts give effect for our <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">two-for-one</FONT></FONT> stock split effective December&nbsp;19, 2013. The balance sheet data at
December&nbsp;31, 2017 and 2016, and the income statement data for the years ended December&nbsp;31, 2017, 2016 and 2015, have been derived from the Consolidated Financial Statements included in this Form
<FONT STYLE="white-space:nowrap">10-K.</FONT> This selected financial data should be read in conjunction with &#147;Management&#146;s Discussion and Analysis of Financial Condition and Results of Operations,&#148; and our Consolidated Financial
Statements and the related notes included in Items 7 and 8, respectively, of this Form <FONT STYLE="white-space:nowrap">10-K</FONT> (in thousands, except per share and other operating data). </FONT></P>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="55%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="18" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Years Ended December&nbsp;31,</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2017</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2016</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2015</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2014</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2013</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Consolidated Income Statement Data:</B></FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Net revenue (1)</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3,458,312</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3,183,159</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,779,996</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,438,913</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,154,012</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Operating expenses:</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Practice salaries and benefits</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,337,734</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,031,220</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,753,505</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,543,395</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,361,318</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Practice supplies and other operating expenses</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">120,518</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">118,416</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">98,480</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">89,002</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">82,388</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">General and administrative expenses</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">417,105</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">372,572</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">305,915</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">247,527</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">218,209</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Depreciation and amortization</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">102,879</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">89,264</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">64,228</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">45,990</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">39,966</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:5.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Total operating expenses</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,978,236</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,611,472</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,222,128</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,925,914</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,701,881</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:5.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Income from operations</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">480,076</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">571,687</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">557,868</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">512,999</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">452,131</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Investment and other income</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3,953</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,019</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,844</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,728</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,696</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Interest expense</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(74,559</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(63,092</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(23,110</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(8,891</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(5,415</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Equity in earnings of unconsolidated affiliates</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">952</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3,185</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3,127</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,780</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#151;&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:5.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Total <FONT STYLE="white-space:nowrap">non-operating</FONT> expenses</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(69,654</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(57,888</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(18,139</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(4,383</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(3,719</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Income before income taxes</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">410,422</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">513,799</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">539,729</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">508,616</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">448,412</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Income tax provision</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(90,050</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(189,203</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(204,038</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(191,413</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(167,895</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Net income</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">320,372</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">324,596</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">335,691</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">317,203</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">280,517</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Net loss attributable to noncontrolling interests</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#151;&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">318</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">629</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">78</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#151;&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:5.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Net income attributable to MEDNAX, Inc.</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">320,372</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">324,914</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">336,320</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">317,281</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">280,517</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Per Common and Common Equivalent Share Data:</B></FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Net income attributable to MEDNAX, Inc.:</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Basic</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.47</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.52</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.61</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.22</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.83</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Diluted</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.45</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.49</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.58</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.18</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.78</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Weighted average common shares:</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Basic</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">92,431</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">92,422</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">93,077</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">98,588</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">99,112</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Diluted</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">92,958</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">93,109</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">93,960</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">99,887</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">100,969</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Other Operating Data:</B></FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Number of physicians at end of year</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">4,083</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3,617</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3,240</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,625</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,367</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Number of births</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">808,465</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">807,285</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">803,311</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">799,868</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">790,597</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">NICU admissions</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">112,965</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">112,184</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">111,407</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">108,978</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">102,099</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">NICU patient days</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,990,521</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,977,204</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,960,768</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,919,579</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,847,577</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Number of anesthesia cases</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,924,952</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,827,194</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,533,089</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,284,149</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,045,794</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Consolidated Balance Sheet Data:</B></FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Cash and cash equivalents</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">60,200</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">55,698</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">51,572</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">47,928</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">31,137</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Working capital</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">95,810</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">138,179</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">98,998</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">50,779</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">41,333</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Total assets</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">5,867,278</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">5,339,400</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">4,547,214</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3,608,248</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3,008,716</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Total liabilities</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,800,824</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,578,633</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,109,368</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,342,682</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">665,728</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Borrowings under credit facility</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,110,500</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">963,500</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">533,500</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">568,000</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">27,000</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2023 Senior Notes outstanding</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">750,000</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">750,000</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">750,000</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#151;&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#151;&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Total equity</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3,066,454</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,760,767</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,437,846</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,265,566</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,342,988</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
</TABLE> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="3%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">(1)</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">The increase in net revenue related to acquisitions was $256.0&nbsp;million, $356.4&nbsp;million, $345.7&nbsp;million, $205.4&nbsp;million and $265.0&nbsp;million for
the years ended December&nbsp;31, 2017, 2016, 2015, 2014 and 2013, respectively. </FONT></TD></TR></TABLE>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">47 </FONT></P>



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<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="9%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><A NAME="tx463027_9"></A>ITEM&nbsp;7.</B></FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>MANAGEMENT&#146;S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS </B></FONT></TD></TR></TABLE>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The following discussion highlights the principal factors that have affected our financial condition and results of operations as well as
our liquidity and capital resources for the periods described. This discussion should be read in conjunction with our Consolidated Financial Statements and the related notes included in Item 8 of this Form
<FONT STYLE="white-space:nowrap">10-K.</FONT> This discussion contains forward-looking statements. Please see the explanatory note concerning &#147;Forward-Looking Statements&#148; preceding Part I of this Form
<FONT STYLE="white-space:nowrap">10-K</FONT> and Item 1A. Risk Factors for a discussion of the uncertainties, risks and assumptions associated with these forward-looking statements. The operating results for the periods presented were not
significantly affected by inflation. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>OVERVIEW </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">MEDNAX is a leading provider of physician services including newborn, anesthesia, maternal-fetal, radiology and teleradiology, pediatric cardiology and other pediatric subspecialty care. At
December&nbsp;31, 2017, our national network comprised over 4,075 affiliated physicians, including 1,175 physicians who provide neonatal clinical care, in 37 states and Puerto Rico, primarily within hospital-based NICUs, to babies born prematurely
or with medical complications. We have 1,400 affiliated physicians who provide anesthesia care to patients in connection with surgical and other procedures, as well as pain management. In addition, we have 325 affiliated physicians who provide
maternal-fetal and obstetrical medical care to expectant mothers experiencing complicated pregnancies primarily in areas where our affiliated neonatal physicians practice. Our network also includes other pediatric subspecialists, including 175
physicians providing pediatric intensive care, 110 physicians providing pediatric cardiology care, 130 physicians providing hospital-based pediatric care, 20 physicians providing pediatric surgical care, and eight physicians providing pediatric ear,
nose and throat and pediatric ophthalmology services. MEDNAX also provides radiology services including diagnostic imaging and interventional radiology, through a network of 285 affiliated physicians, as well as teleradiology services in all 50
states, the District of Columbia and Puerto Rico through a network of 445 affiliated radiologists. In addition to our national physician network, we provide services nationwide to healthcare facilities and physicians, including ours, through
complementary businesses, consisting of a management services organization focusing on full-service revenue cycle management and a consulting services company. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B><I>2017 Acquisition Activity </I></B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">During 2017, we completed 10 physician
group practice acquisitions, including four radiology practices, two maternal-fetal medicine practices, one neonatology practice, one pediatric multi-specialty practice and two other pediatric subspecialty practices. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Based on our experience, we expect that we can improve the results of all of our acquired physician practices through improved managed
care contracting, improved collections, identification of growth initiatives, as well as, operating and cost savings based upon the significant infrastructure that we have developed. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B><I>General Economic Conditions </I></B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our operations and performance depend
significantly on economic conditions. During the year ended December&nbsp;31, 2017, the percentage of our patient service revenue being reimbursed under government-sponsored or funded healthcare programs (the &#147;GHC Programs&#148;), increased
slightly as compared to the year ended December&nbsp;31, 2016. We could experience additional shifts toward GHC Programs and patient volumes could decline if economic conditions deteriorate. Payments received from GHC Programs are substantially less
for equivalent services than payments received from commercial insurance payors. In addition, due to the rising costs of managed care premiums and patient responsibility amounts, we may experience increased bad debt due to patients&#146; inability
to pay for certain services. See Item 1A. Risk Factors, in this Form <FONT STYLE="white-space:nowrap">10-K</FONT> for additional discussion on the general economic conditions in the United States and recent developments in the healthcare industry
that could affect our business. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">48 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Healthcare Reform </I></B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The Patient Protection and Affordable Care Act (the &#147;ACA&#148;) contains a number of provisions that have affected us and, absent amendment or repeal, may continue to affect us over the next several
years. These provisions include the establishment of health insurance exchanges to facilitate the purchase of qualified health plans, expanded Medicaid eligibility, subsidized insurance premiums and additional requirements and incentives for
businesses to provide healthcare benefits. Other provisions have expanded the scope and reach of Federal civil False Claims Act (&#147;FCA&#148;) and other healthcare fraud and abuse laws. Moreover, we could be affected by potential changes to
various aspects of the ACA, including subsidies, healthcare insurance marketplaces and Medicaid expansion. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The ACA remains
subject to continuing legislative and administrative scrutiny, including efforts by the Republican-controlled Congress and the current Administration to amend or repeal a number of its provisions, as well as administrative actions delaying the
effectiveness of key provisions. If the ACA is repealed or substantially modified, or if implementation of certain aspects of the ACA are diluted or delayed, such repeal, modification or delay may impact our business, financial condition, results of
operations, cash flows and the trading price of our securities.&nbsp;We are unable to predict the impact of any repeal, modification or delay in the implementation of the ACA on us at this time. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In addition to the potential impacts to the ACA under the current Administration, there could be more sweeping changes to GHC Programs,
such as a change in the structure of Medicaid by converting it into a block grant or instituting &#147;per capita caps,&#148; which could eliminate the guarantee that everyone who is eligible and applies for benefits would receive them and could
potentially give states sweeping new authority to restrict eligibility, cut benefits and make it more difficult for people to enroll. Additionally, several states are considering and pursuing changes to their Medicaid programs, such as requiring
recipients to engage in employment activities as a condition of eligibility for most adults, disenrolling recipients for failure to pay a premium, or adjusting premium amounts based on income. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">As a result, we cannot predict with any assurance the ultimate effect of these laws and resulting changes to payments under GHC Programs,
nor can we provide any assurance that they will not have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. Further, any fiscal tightening impacting GHC Programs
or changes to the structure of any GHC Programs could have a material adverse effect on our financial condition, results of operations, cash flows and the trading price of our securities. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B><I>The Medicare Access and CHIP Reauthorization Act </I></B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Medicare pays for
most physician services based upon a national service-specific fee schedule. In 2015, Congress enacted the Medicare Access and CHIP Reauthorization Act (&#147;MACRA,&#148;) which provides physicians 0.5% annual increases in reimbursement through
2019 as Medicare transitions to a payment system designed to reward physicians for the quality of care provided, rather than the quantity of procedures performed. MACRA will require physicians to choose to participate in one of two payment formulas,
Merit-Based Incentive Payment System (&#147;MIPS&#148;) or Alternative Payment Models (&#147;APMs&#148;). Beginning in 2019, MIPS will allow eligible physicians to receive incentive payments based on the achievement of certain quality and cost
metrics, among other measures, and be reduced for those who are underperforming against those same metrics and measures. As an alternative, physicians can choose to participate in an Advanced APM. Advanced APMs are exempt from the MIPS requirements,
and physicians who are meaningful participants in APMs will receive bonus payments from Medicare pursuant to the law. We will continue to operationalize the provisions of MACRA and assess any further changes to the law or additional regulations
enacted pursuant to the law. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">At this time we cannot predict the ultimate effect that these changes will have on us, nor can
we provide any assurance that its provisions will not have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">49 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Medicaid to Medicare Payment Parity </I></B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In 2012, CMS adopted a rule under the ACA that generally allowed physicians who provided eligible primary care services to be paid at the
Medicare reimbursement rates in effect in calendar years 2013 and 2014 instead of state-established Medicaid reimbursement rates that would have been applicable in those years (&#147;parity revenue&#148;). Federal funding for the enhanced Medicaid
payments expired for dates of service beyond December&nbsp;31, 2014. Advocacy efforts by various parties took place at both the federal and state legislative levels to continue this program, but only a limited number of states committed to either
extend this program, at least in part, for a limited period of time or increase their <FONT STYLE="white-space:nowrap">pre-parity</FONT> base Medicaid rates. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">We did not recognize any parity revenue during the years ended December&nbsp;31, 2017 and 2016. During the year ended December&nbsp;31, 2015, we recognized $12.0&nbsp;million in parity revenue that
contributed $0.04 to our net income per diluted share, reflecting the impacts from incentive compensation and income taxes. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Medicaid
Expansion </I></B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The ACA also allows states to expand their Medicaid programs through federal payments that fund most of the
cost of increasing the Medicaid eligibility income limit from a state&#146;s historic eligibility levels to 133% of the federal poverty level. As of December&nbsp;31, 2017, 32 states and the District of Columbia had expanded Medicaid eligibility.
All of the states in which we operate, however, already cover children in the first year of life and pregnant women if their household income is at or below 133% of the federal poverty level. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B><I>Medicare Sequestration </I></B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Budget Control Act of 2011, as amended
by the American Taxpayer Relief Act of 2012, required <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">across-the-board</FONT></FONT> cuts (&#147;sequestrations&#148;) to Medicare reimbursement rates. These annual reductions of 2%,
on average, began in April 2013 and apply to mandatory and discretionary spending in the years 2013 to 2025. Unless Congress takes action in the future to modify these sequestrations, Medicare reimbursements will be reduced by 2%, on average,
annually. However, this reduction in Medicare reimbursement rates is not expected to have a material adverse effect on our business, financial condition, results of operations, cash flows or the trading price of our securities. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Geographic Coverage </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">During 2017, 2016 and 2015, approximately 51%, 51% and 54%, respectively, of our net revenue was generated by operations in our five
largest states. During 2017, 2016 and 2015, our five largest states consisted of Texas, North Carolina, Georgia, Tennessee and Florida. During 2017, 2016 and 2015, our operations in Texas accounted for approximately 19%, 19% and 20%, respectively,
of our net revenue. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Payor Mix </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">We bill payors for professional services provided by our affiliated physicians to our patients based upon rates for specific services provided. Our billed charges are substantially the same for all
parties in a particular geographic area regardless of the party responsible for paying the bill for our services. We determine our net revenue based upon the difference between our gross fees for services and our estimated ultimate collections from
payors. Net revenue differs from gross fees due to (i)&nbsp;managed care payments at contracted rates, (ii)&nbsp;GHC Program reimbursements at government-established rates, (iii)&nbsp;various reimbursement plans and negotiated reimbursements from
other third-parties, and (iv)&nbsp;discounted and uncollectible accounts of <FONT STYLE="white-space:nowrap">private-pay</FONT> patients. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Our payor mix is composed of contracted managed care, government, principally Medicare and Medicaid, other third-parties and <FONT STYLE="white-space:nowrap">private-pay</FONT> patients. We benefit from
the fact that most of the medical services provided in the NICU are classified as emergency services, a category typically classified as a covered service by managed care payors. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">50 </FONT></P>



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 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following is a summary of our payor mix, expressed as a percentage of net revenue, exclusive
of administrative fees and revenue related to our <FONT STYLE="white-space:nowrap">non-practice</FONT> service offerings, for the periods indicated: </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="75%"></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years&nbsp;Ended&nbsp;December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2017</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2015</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Contracted managed care</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">70</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">70</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">70</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Government</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">25</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">23</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">23</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Other third-parties</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><FONT STYLE="white-space:nowrap">Private-pay</FONT> patients</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">100</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">100</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">100</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The payor mix shown in the table above is not necessarily representative of the amount of services provided to
patients covered under these plans. For example, the gross amount billed to patients covered under GHC Programs for the years ended December&nbsp;31, 2017, 2016 and 2015 represented approximately 55% of our total gross patient service revenue. These
percentages of gross revenue and the percentages of net revenue provided in the table above include the payor mix impact of acquisitions completed through December&nbsp;31, 2017. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Quarterly Results </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We have historically
experienced and expect to continue to experience quarterly fluctuations in net revenue and net income. These fluctuations are primarily due to the following factors: </P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top">There are fewer calendar days in the first and second quarters of the year, as compared to the third and fourth quarters of the year. Because we provide services in NICUs on a <FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">24-hours-a-day</FONT></FONT></FONT> basis, 365 days a year, any reduction in service days will have a corresponding reduction in net revenue. </TD></TR></TABLE>
<P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top">The majority of physician services provided by our office-based and anesthesia practices consist of office visits and scheduled procedures that occur during business hours. As a result, volumes at those practices
fluctuate based on the number of business days in each calendar quarter. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top">A significant number of our employees and our associated professional contractors, primarily physicians, exceed the level of taxable wages for social security during the first and second quarters of the year. As a
result, we incur a significantly higher payroll tax burden and our net income is lower during those quarters. </TD></TR></TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We have
significant fixed operating costs, including physician compensation, and, as a result, are highly dependent on patient volume and capacity utilization of our affiliated professional contractors to sustain profitability. Additionally, quarterly
results may be affected by the timing of acquisitions and fluctuations in patient volume. As a result, the operating results for any quarter are not necessarily indicative of results for any future period or for the full year. Our unaudited
quarterly results are presented in further detail in Note 17 to our Consolidated Financial Statements in this Form <FONT STYLE="white-space:nowrap">10-K.</FONT> </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Application of Critical Accounting Policies and Estimates </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The preparation of financial statements in conformity with accounting principles generally accepted in the United States (&#147;GAAP&#148;)
requires estimates and assumptions that affect the reporting of assets, liabilities, revenue and expenses, and the disclosure of contingent assets and liabilities. Note 2 to our Consolidated Financial Statements provides a summary of our significant
accounting policies, which are all in accordance with GAAP. Certain of our accounting policies are critical to understanding our Consolidated Financial Statements because their application requires management to make assumptions about future results
and depends to a large extent on management&#146;s judgment, because past results have fluctuated and are expected to continue to do so in the future. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We believe that the application of the accounting policies described in the following paragraphs is highly dependent on critical estimates and
assumptions that are inherently uncertain and highly susceptible to change. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">51 </P>


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For all of these policies, we caution that future events rarely develop exactly as estimated, and the best estimates routinely require adjustment. On an ongoing basis, we evaluate our estimates
and assumptions, including those discussed below. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Revenue Recognition </I></B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We recognize patient service revenue at the time services are provided by our affiliated physicians. Almost all of our patient service
revenue is reimbursed by GHC Programs and third-party insurance payors. Payments for services rendered to our patients are generally less than billed charges. We monitor our revenue and receivables from these sources and record an estimated
contractual allowance to properly account for the anticipated differences between billed and reimbursed amounts. Accordingly, patient service revenue is presented net of an estimated provision for contractual adjustments and uncollectibles.
Management estimates allowances for contractual adjustments and uncollectibles on accounts receivable based upon historical experience and other factors, including days sales outstanding (&#147;DSO&#148;) for accounts receivable, evaluation of
expected adjustments and delinquency rates, past adjustments and collection experience in relation to amounts billed, an aging of accounts receivable, current contract and reimbursement terms, changes in payor mix and other relevant information.
Contractual adjustments result from the difference between the physician rates for services performed and the reimbursements by GHC Programs and third-party insurance payors for such services. The evaluation of these historical and other factors
involves complex, subjective judgments. On a routine basis, we compare our cash collections to recorded net patient service revenue and evaluate our historical allowance for contractual adjustments and uncollectibles based upon the ultimate
resolution of the accounts receivable balance. These procedures are completed regularly in order to monitor our process of establishing appropriate reserves for contractual adjustments. We have not recorded any material adjustments to prior period
contractual adjustments and uncollectibles in the years ended December&nbsp;31, 2017, 2016, or 2015. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">DSO is one of the key
factors that we use to evaluate the condition of our accounts receivable and the related allowances for contractual adjustments and uncollectibles. DSO reflects the timeliness of cash collections on billed revenue and the level of reserves on
outstanding accounts receivable. Any significant change in our DSO results in additional analyses of outstanding accounts receivable and the associated reserves. We calculate our DSO using a three-month rolling average of net revenue. Our net
revenue, net income and operating cash flows may be materially and adversely affected if actual adjustments and uncollectibles exceed management&#146;s estimated provisions as a result of changes in these factors. As of December&nbsp;31, 2017, our
DSO was 50.9 days. We had approximately $1.8&nbsp;billion in gross accounts receivable outstanding at December&nbsp;31, 2017, and considering this outstanding balance, based on our historical experience, a reasonably likely change of 0.5% to 1.50%
in our estimated collection rate would result in an impact to net revenue of $9.0 million to $26.9&nbsp;million. The impact of this change does not include adjustments that may be required as a result of audits, inquiries and investigations from
government authorities and agencies and other third-party payors that may occur in the ordinary course of business. See Note 16 to our Consolidated Financial Statements in this Form <FONT STYLE="white-space:nowrap">10-K.</FONT> </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Professional Liability Coverage </I></B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">We maintain professional liability insurance policies with third-party insurers generally on a claims-made basis, subject to self-insured retention, exclusions and other restrictions. Our self-insured
retention under our professional liability insurance program is maintained primarily through a wholly owned captive insurance subsidiary. We record liabilities for self-insured amounts and claims incurred but not reported based on an actuarial
valuation using historical loss information, claim emergence patterns and various actuarial assumptions. Liabilities for claims incurred but not reported are not discounted. The average lag period from the date a claim is reported to the date it
reaches final settlement is approximately four years, although the facts and circumstances of individual claims could result in lag periods that vary from this average. Our actuarial assumptions incorporate multiple complex methodologies to
determine the best liability estimate for claims incurred but not reported and the future development of known claims, including methodologies that focus on industry trends, paid loss development, reported loss development and industry-based
expected pure premiums. The most significant </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">52 </FONT></P>



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assumptions used in the estimation process include the use of loss development factors to determine the future emergence of claim liabilities, the use of frequency and trend factors to estimate
the impact of economic, judicial and social changes affecting claim costs, and assumptions regarding legal and other costs associated with the ultimate settlement of claims. The key assumptions used in our actuarial valuations are subject to
constant adjustments as a result of changes in our actual loss history and the movement of projected emergence patterns as claims develop. We evaluate the need for professional liability insurance reserves in excess of amounts estimated in our
actuarial valuations on a routine basis, and as of December&nbsp;31, 2017, based on our historical experience, a reasonably likely change of 4% to 6% in our estimates would result in an increase or decrease to net income of $2.7&nbsp;million to
$5.0&nbsp;million. However, because many factors can affect historical and future loss patterns, the determination of an appropriate professional liability reserve involves complex, subjective judgment, and actual results may vary significantly from
estimates. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Goodwill </I></B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">We record acquired assets, including identifiable intangible assets and liabilities at their respective fair values, recording to goodwill the excess of purchase price over the fair value of the net
assets acquired. We test goodwill for impairment at a reporting unit level on an annual basis, and more frequently if impairment indicators exist. The Company early adopted new accounting guidance in 2017 that requires only a single-step
quantitative test with any goodwill impairment measured as the amount by which a reporting unit&#146;s carrying value exceeds its fair value. We use income and market-based valuation approaches to determine the fair value of our reporting units.
These approaches focus on discounted cash flows and market multiples based on our market capitalization to derive the fair value of a reporting unit. We also consider the economic outlook for the healthcare services industry and various other
factors during the testing process, including hospital and physician contract changes, local market developments, changes in third-party payor payments, and other publicly available information. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Other Matters </I></B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Other significant accounting policies, not involving the same level of measurement uncertainties as those discussed above, are
nevertheless important to an understanding of our Consolidated Financial Statements. For example, our Consolidated Financial Statements are presented on a consolidated basis with our affiliated professional contractors because we or one of our
subsidiaries have entered into management agreements with our affiliated professional contractors meeting the &#147;controlling financial interest&#148; criteria set forth in accounting guidance for consolidations. Our management agreements are
further described in Note 2 to our Consolidated Financial Statements in this Form <FONT STYLE="white-space:nowrap">10-K.</FONT> The policies described in Note 2 often require difficult judgments on complex matters that are often subject to multiple
sources of authoritative guidance and are frequently reexamined by accounting standards setters and regulators. See &#147;New Accounting Pronouncements&#148; below for matters that may affect our accounting policies in the future. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><FONT STYLE="white-space:nowrap">Non-GAAP</FONT> Measures </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">In our analysis of our results of operations, we use certain <FONT STYLE="white-space:nowrap">non-GAAP</FONT> financial measures. Earnings before interest, taxes and depreciation and amortization
(&#147;EBITDA&#148;) consists of net income attributable to MEDNAX, Inc. before interest expense, income tax provision and depreciation and amortization. The Company had historically included immaterial investment and other income and equity in
earnings of unconsolidated affiliates as a component of the interest expense adjustment within EBITDA. Beginning in the fourth quarter of 2017, the Company has excluded these items such that the interest expense adjustment represents only interest
expense and has conformed its previous EBITDA calculations with the current period presentation. Adjusted earnings per common share (&#147;Adjusted EPS&#148;) consists of diluted net income attributable to MEDNAX, Inc. per common and common
equivalent share adjusted for amortization expense and stock-based compensation expense. Adjusted EPS for the year ended December&nbsp;31, 2017 excludes the net income tax benefit related to the reduction in our net deferred tax liability resulting
from the reduction in the corporate tax rate enacted in December 2017 under the </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">53 </FONT></P>



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Tax Cuts and Jobs Act of 2017. Additionally, Adjusted EPS for the year ended December&nbsp;31, 2016 excludes the net income tax benefit resulting from the reversal of a liability for uncertain
tax positions related to the favorable settlement of a tax matter during the third quarter of 2016. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We believe these
measures, in addition to income from operations, net income attributable to MEDNAX, Inc. and diluted net income attributable to MEDNAX, Inc. per common and common equivalent share, provide investors with useful supplemental information to compare
and understand our underlying business trends and performance across reporting periods on a consistent basis. These measures should be considered a supplement to, and not a substitute for, financial performance measures determined in accordance with
GAAP. In addition, since these <FONT STYLE="white-space:nowrap">non-GAAP</FONT> measures are not determined in accordance with GAAP, they are susceptible to varying calculations and may not be comparable to other similarly titled measures of other
companies. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">For a reconciliation of each of EBITDA and Adjusted EPS to the most directly comparable GAAP measures for the
years ended December&nbsp;31, 2017, 2016 and 2015, refer to the tables below (in thousands, except per share data). In addition, historical reconciliations of EBITDA and Adjusted EPS are available on our internet website at www.mednax.com under the
Investors tab. Our internet website and the information contained therein or connected thereto are not incorporated into or deemed a part of this Form <FONT STYLE="white-space:nowrap">10-K.</FONT> </FONT></P>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="61%"></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Years Ended December&nbsp;31,</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2017</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2016</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2015</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Net income attributable to MEDNAX, Inc.</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">320,372</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">324,914</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">336,320</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Interest expense</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">74,559</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">63,092</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">23,110</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Income tax provision</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">90,050</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">189,203</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">204,038</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Depreciation and amortization</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">102,879</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">89,264</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">64,228</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">EBITDA</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">587,860</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">666,473</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">627,696</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="56%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="22" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Years Ended December&nbsp;31,</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2017</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2016</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2015</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Weighted average diluted shares outstanding</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="5" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">92,958</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="5" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">93,109</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="5" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">93,960</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Net income and diluted net income per share attributable to MEDNAX, Inc.</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">320,372</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.45</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">324,914</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.49</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">336,320</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.58</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Adjustments:</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Amortization (net of tax of $26,902, $23,443 and $15,876)</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">42,079</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">0.45</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">36,873</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">0.39</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">26,170</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">0.28</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Stock-based compensation (net of tax of $11,534, $13,216 and $12,132)</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">18,039</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">0.19</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">20,784</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">0.22</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">19,997</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">0.21</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Income tax benefits</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(70,014</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(0.75</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(10,646</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(0.11</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#151;&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#151;&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Adjusted net income and diluted EPS</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">310,476</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.34</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">371,925</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.99</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">382,487</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.07</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">54 </FONT></P>



<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>RESULTS OF OPERATIONS </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The following table sets forth, for the periods indicated, certain information related to our operations expressed as a percentage of our net revenue: </FONT></P>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="72%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Years&nbsp;Ended&nbsp;December&nbsp;31,</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>&nbsp;&nbsp;2017&nbsp;&nbsp;</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>&nbsp;&nbsp;2016&nbsp;&nbsp;</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>&nbsp;&nbsp;2015&nbsp;&nbsp;</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Net revenue</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">100.0</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">100.0</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">100.0</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Operating expenses:</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Practice salaries and benefits</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">67.6</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">63.8</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">63.1</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Practice supplies and other</FONT></P>
<P STYLE="margin-top:0px;margin-bottom:1px; margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">operating expenses</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.5</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.7</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.5</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">General and administrative expenses</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">12.1</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">11.7</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">11.0</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Depreciation and amortization</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.9</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.8</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.3</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:5.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Total operating expenses</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">86.1</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">82.0</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">79.9</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Income from operations</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">13.9</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">18.0</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">20.1</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:5.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2"><FONT STYLE="white-space:nowrap">Non-operating</FONT> expense, net</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.0</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1.8</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">0.7</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Income before income taxes</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">11.9</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">16.2</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">19.4</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Income tax provision</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.6</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">6.0</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">7.3</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Net income</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">9.3</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">10.2</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">12.1</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Year Ended December&nbsp;31, 2017 as Compared to Year Ended December&nbsp;31, 2016 </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our net revenue increased $275.2&nbsp;million, or 8.6%, to $3.46&nbsp;billion for the year ended December&nbsp;31, 2017, as compared to
$3.18&nbsp;billion for 2016. Of this $275.2&nbsp;million increase, $256.0&nbsp;million, or 7.9%, was attributable to revenue generated from acquisitions completed after December&nbsp;31, 2015. Same-unit net revenue increased $19.1&nbsp;million, or
0.7%, for the year ended December&nbsp;31, 2017. Same units are those units at which we provided services for the entire current period and the entire comparable period. The increase in same-unit net revenue was comprised of a net increase of
$11.7&nbsp;million, or 0.4%, related to net reimbursement-related factors and an increase in revenue of $7.4&nbsp;million, or 0.3%, from patient service volumes. The net increase in revenue of $11.7&nbsp;million related to net reimbursement-related
factors was primarily due to modest improvements in managed care contracting and an increase in the administrative fees received from our hospital partners, partially offset by a decrease in revenue caused by an increase in the percentage of our
patients enrolled in GHC Programs. The increase in revenue of $7.4&nbsp;million from patient service volumes was primarily related to growth across our anesthesiology, neonatology and maternal-fetal medicine services, partially offset by a decrease
in our other pediatric services, primarily hearing screen services. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Practice salaries and benefits increased
$306.5&nbsp;million, or 15.1%, to $2.34&nbsp;billion for the year ended December&nbsp;31, 2017, as compared to $2.03&nbsp;billion for 2016. This $306.5&nbsp;million increase was primarily attributable to increased costs associated with new
physicians and other staff to support acquisition-related growth and growth at existing units, of which $230.6&nbsp;million was related to salaries and $75.9&nbsp;million was related to benefits and incentive compensation. Included within the
increase in salaries expense at our existing units were costs related to clinician compensation that increased at a faster rate than in previous periods. We anticipate that we will continue to experience a higher rate of growth in clinician
compensation expense, which could adversely affect our business, financial condition, results of operations, cash flows and the trading price of our securities. Included within the increase in benefits expense were increased costs related to
malpractice expense driven by unfavorable claims experience. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Practice supplies and other operating expenses increased
$2.1&nbsp;million, or 1.8%, to $120.5&nbsp;million for the year ended December&nbsp;31, 2017, as compared to $118.4&nbsp;million for 2016. The increase was attributable to practice </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">55 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
supply, rent and other costs related to our acquisitions, partially offset by a decrease at our existing units. The decrease at our existing units was primarily attributable to the
reclassification of certain temporary staffing costs from practice operating expenses to practice salaries in 2017. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">General
and administrative expenses include all billing and collection functions and all other salaries, benefits, supplies and operating expenses not specifically related to the
<FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">day-to-day</FONT></FONT> operations of our physician practices and services, as well as those attributable to our <FONT STYLE="white-space:nowrap">non-physician</FONT> service
businesses. General and administrative expenses increased $44.5&nbsp;million, or 12.0%, to $417.1&nbsp;million for the year ended December&nbsp;31, 2017, as compared to $372.6&nbsp;million for 2016. The increase of $44.5&nbsp;million is attributable
to the overall growth of the Company. General and administrative expenses as a percentage of net revenue was 12.1% for the year ended December&nbsp;31, 2017, as compared to 11.7% for the same period in 2016. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Depreciation and amortization expense increased $13.6&nbsp;million, or 15.3%, to $102.9&nbsp;million for the year ended December&nbsp;31,
2017, as compared to $89.3&nbsp;million for 2016. The increase was primarily attributable to the amortization of intangible assets related to acquisitions. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Income from operations decreased $91.6&nbsp;million, or 16.0%, to $480.1&nbsp;million for the year ended December&nbsp;31, 2017, as compared to $571.7&nbsp;million for 2016. Our operating margin was 13.9%
for the year ended December&nbsp;31, 2017, as compared to 18.0% for 2016. The decrease of 408 basis points was primarily due to increases in operating expenses and lower same-unit revenue. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Net <FONT STYLE="white-space:nowrap">non-operating</FONT> expenses were $69.7&nbsp;million for the year ended December&nbsp;31, 2017, as
compared to $57.9&nbsp;million for 2016. The net increase in <FONT STYLE="white-space:nowrap">non-operating</FONT> expenses was primarily related to an increase in interest expense due to higher average borrowings outstanding under our credit
agreement (the &#147;Credit Agreement&#148;). </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our effective income tax rate was 21.9% for the year ended December&nbsp;31,
2017, as compared to 36.8% for 2016. After excluding a $70.0&nbsp;million income tax benefit resulting from the reduction of our net deferred tax liability resulting from the reduction in the corporate tax rate enacted under the Tax Cuts and Jobs
Act of 2017 during the fourth quarter of 2017, our effective income tax rate for the year ended December&nbsp;31, 2017 was 39.0%. After excluding a $10.6&nbsp;million income tax benefit resulting from the reversal of a liability for uncertain tax
positions related to the favorable settlement of a tax matter during the third quarter of 2016, our effective income tax rate for the year ended December&nbsp;31, 2016 was 38.9%. We believe that excluding the favorable impacts on our effective
income tax rate related to these income tax benefits provides a more comparable view of our effective income tax rate. After excluding these favorable impacts, our effective tax rate was relatively unchanged. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Net income attributable to MEDNAX, Inc. was $320.4&nbsp;million for the year ended December&nbsp;31, 2017, as compared to
$324.9&nbsp;million for 2016. EBITDA was $587.9&nbsp;million for the year ended December&nbsp;31, 2017, as compared to $666.5&nbsp;million for 2016. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Diluted net income attributable to MEDNAX, Inc. per common and common equivalent share was $3.45 on weighted average shares outstanding of 93.0&nbsp;million for the year ended December&nbsp;31, 2017, as
compared to $3.49 on weighted average shares outstanding of 93.1&nbsp;million for 2016. Adjusted EPS was $3.34 for the year ended December&nbsp;31, 2017, as compared to $3.99 for 2016. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Year Ended December&nbsp;31, 2016 as Compared to Year Ended December&nbsp;31, 2015 </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Our net revenue increased $403.2&nbsp;million, or 14.5%, to $3.18&nbsp;billion for the year ended December&nbsp;31, 2016, as compared to $2.78&nbsp;billion for 2015. Of this $403.2&nbsp;million increase,
$356.4&nbsp;million, or 12.7%, was attributable to revenue generated from acquisitions completed after December&nbsp;31, 2014. Same-unit net revenue increased $46.8&nbsp;million, or 1.8%, for the year ended December&nbsp;31, 2016. Same units are
those units at which we provided </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">56 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
services for the entire current period and the entire comparable period. The increase in same-unit net revenue was comprised of a net increase of $34.2&nbsp;million, or 1.3%, related to net
reimbursement-related factors and an increase in revenue of $12.6&nbsp;million, or 0.5%, from patient service volumes. The net increase in revenue of $34.2&nbsp;million related to net reimbursement-related factors was primarily due to continued
modest improvements in managed care contracting and the flow through of revenue from modest price increases, partially offset by the unfavorable impact from the decrease in parity revenue as there was no parity recorded during the year ended
December&nbsp;31, 2016, as compared to the year ended December&nbsp;31, 2015, and the decrease in revenue caused by an increase in the percentage of our patients enrolled in GHC Programs. The increase in revenue of $12.6&nbsp;million from patient
service volumes was primarily related to growth in our anesthesiology and other pediatric services, primarily newborn nursery, partially offset by decreases in our neonatology services and our maternal-fetal medicine services. Our overall same-unit
revenue increased $58.8&nbsp;million, or 2.3%, after excluding the unfavorable impact of the $12.0&nbsp;million decrease in parity revenue, and our revenue from <FONT STYLE="white-space:nowrap">net-reimbursement</FONT> related factors increased by
$46.2&nbsp;million, or 1.8%, after excluding this same unfavorable impact. We believe that excluding the unfavorable impact from the decrease in parity revenue year over year provides a more comparable view of our changes in same-unit revenue.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Practice salaries and benefits increased $277.7&nbsp;million, or 15.8%, to $2.03&nbsp;billion for the year ended
December&nbsp;31, 2016, as compared to $1.75&nbsp;billion for 2015. This $277.7&nbsp;million increase was primarily attributable to increased costs associated with new physicians and other staff to support acquisition-related growth and growth at
existing units, of which $251.5&nbsp;million was related to salaries and $26.2&nbsp;million was related to benefits and incentive compensation. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Practice supplies and other operating expenses increased $19.9&nbsp;million, or 20.2%, to $118.4&nbsp;million for the year ended December&nbsp;31, 2016, as compared to $98.5&nbsp;million for 2015. The
increase was attributable to practice supply, rent and other costs related to our acquisitions as well as increases at existing units. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">General and administrative expenses include all billing and collection functions and all other salaries, benefits, supplies and operating expenses not specifically related to the <FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">day-to-day</FONT></FONT> operations of our physician practices and services, as well as those attributable to our <FONT STYLE="white-space:nowrap">non-physician</FONT> service businesses.
General and administrative expenses increased $66.7&nbsp;million, or 21.8%, to $372.6&nbsp;million for the year ended December&nbsp;31, 2016, as compared to $305.9&nbsp;million for 2015. The increase of $66.7&nbsp;million is attributable to the
overall growth of the Company including acquisition-related growth. General and administrative expenses as a percentage of net revenue was 11.7% for the year ended December&nbsp;31, 2016, as compared to 11.0% for the same period in 2015. The
increase of 70 basis points was driven by the mix of acquisitions, primarily our <FONT STYLE="white-space:nowrap">non-practice</FONT> physician services business. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Depreciation and amortization expense increased $25.1&nbsp;million, or 39.0%, to $89.3&nbsp;million for the year ended December&nbsp;31, 2016, as compared to $64.2&nbsp;million for 2015. The increase was
primarily attributable to the amortization of intangible assets related to acquisitions. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Income from operations increased
$13.8&nbsp;million, or 2.5%, to $571.7&nbsp;million for the year ended December&nbsp;31, 2016, as compared to $557.9&nbsp;million for 2015. Our operating margin was 18.0% for the year ended December&nbsp;31, 2016, as compared to 20.1% for 2015. The
decrease of 211 basis points was primarily due to the variability in margins related to the mix of acquisitions completed after December&nbsp;31, 2014. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Net <FONT STYLE="white-space:nowrap">non-operating</FONT> expenses were $57.9&nbsp;million for the year ended December&nbsp;31, 2016, as compared to $18.1&nbsp;million for 2015. The net increase in <FONT
STYLE="white-space:nowrap">non-operating</FONT> expenses was primarily related to an increase in interest expense related to our senior unsecured notes due 2023 (the &#147;Senior Notes&#148;) and higher outstanding borrowings under our Credit
Agreement. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our effective income tax rate was 36.8% for the year ended December&nbsp;31, 2016, as compared to 37.8% for 2015.
After excluding a $10.6&nbsp;million income tax benefit resulting from the reversal of a liability for uncertain </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">57 </FONT></P>



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tax positions related to the favorable settlement of a tax matter during the third quarter of 2016, our effective income tax rate for the year ended December&nbsp;31, 2016 was 38.9%. We believe
that excluding the favorable impact on our effective income tax rate related to the settlement provides a more comparable view of our effective income tax rate. After excluding this favorable impact, the effective tax rate increased by 111 basis
points, from 37.8% at December&nbsp;31, 2015 to 38.9% at December&nbsp;31, 2016, primarily reflecting the impact from certain favorable <FONT STYLE="white-space:nowrap">non-recurring</FONT> items that occurred in 2015 and an increase in our
valuation allowance on deferred taxes in 2016. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Net income attributable to MEDNAX, Inc. was $324.9&nbsp;million for the year
ended December&nbsp;31, 2016, as compared to $336.3&nbsp;million for 2015. EBITDA increased by 6.2% to $666.5&nbsp;million for the year ended December&nbsp;31, 2016, as compared to $627.7&nbsp;million for 2015. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Diluted net income attributable to MEDNAX, Inc. per common and common equivalent share was $3.49 on weighted average shares outstanding
of 93.1&nbsp;million for the year ended December&nbsp;31, 2016, as compared to $3.58 on weighted average shares outstanding of 94.0&nbsp;million for 2015. Adjusted EPS was $3.99 for the year ended December&nbsp;31, 2016, as compared to $4.07 for
2015. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>LIQUIDITY AND CAPITAL RESOURCES </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">As of December&nbsp;31, 2017, we had $60.2&nbsp;million of cash and cash equivalents on hand as compared to $55.7&nbsp;million at December&nbsp;31, 2016. Additionally, we had working capital of
$95.8&nbsp;million at December&nbsp;31, 2017, a decrease of $42.4&nbsp;million from our working capital of $138.2&nbsp;million at December&nbsp;31, 2016. This net decrease in working capital is primarily due to the use of funds for acquisitions and
repurchases of our common stock as well as a decrease in our long-term deferred tax liability resulting from the decrease in the corporate tax rate enacted under the Tax Cuts and Jobs Act of 2017, partially offset by 2017 earnings, net borrowings on
our Credit Agreement, increases in our long-term professional liabilities and proceeds from the issuance of common stock under our Amended and Restated 2008 Incentive Plan, our 1996 <FONT STYLE="white-space:nowrap">Non-Qualified</FONT> Employee
Stock Purchase Plan, as amended (the &#147;ESPP&#148;), and our 2015 <FONT STYLE="white-space:nowrap">Non-Qualified</FONT> Stock Purchase Plan (the &#147;SPP&#148;). </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Cash Flows </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">Cash provided by (used in) operating, investing and financing activities is
summarized as follows (in thousands): </FONT></P> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="60%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Years Ended December&nbsp;31,</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2017</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2016</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2015</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Operating activities</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">511,378</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">443,778</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">368,701</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Investing activities</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(576,613</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(821,217</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(848,000</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Financing activities</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">89,737</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">381,565</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">482,943</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
</TABLE> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Operating Activities </I></B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">We generated cash flow from operating activities of $511.4&nbsp;million, $443.8&nbsp;million and $368.7&nbsp;million for the years ended December&nbsp;31, 2017, 2016 and 2015, respectively. The net
increase of $67.6&nbsp;million in cash flow provided from operating activities for the year ended December&nbsp;31, 2017, as compared to the year ended December&nbsp;31, 2016, was primarily related to a net increase in cash flow related to an
increase in income taxes payable resulting from fewer tax payments made due to a deferral allowed by the Internal Revenue Service for companies impacted by the hurricanes as well as an increase in cash flow due to decreases in accounts receivable,
net of acquired accounts receivable and increases in professional liability reserves, partially offset by lower earnings. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">During the year ended December&nbsp;31, 2017, accounts receivable increased by $8.7&nbsp;million, as compared to an increase of
$50.5&nbsp;million for 2016. The increases in accounts receivable are primarily due to higher accounts receivable balances related to acquisitions as well as increases at our existing units. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">58 </FONT></P>



<p Style='page-break-before:always'>
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<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Our cash flow from operating activities is significantly affected by the payment of
physician incentive compensation. A large majority of our affiliated physicians participate in our performance-based incentive compensation program and almost all of the payments due under the program are made annually in the first quarter. As a
result, we typically experience negative cash flow from operations in the first quarter of each year and fund our operations during this period with cash on hand or funds borrowed under our Credit Agreement. In addition, during the first quarter of
each year, we use cash to make any discretionary matching contributions for participants in our qualified contributory savings plans. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">We generated cash flow from operating activities of $443.8&nbsp;million and $368.7&nbsp;million for the years ended December&nbsp;31, 2016 and 2015, respectively. Cash flow for the year ended
December&nbsp;31, 2016 was impacted by an increase in the adjustment to net income for <FONT STYLE="white-space:nowrap">non-cash</FONT> depreciation and amortization expense, a net increase in cash flow related to changes in the components of our
accounts payable and accrued expenses and an increase in cash flow related to accounts receivable. Cash flow for the year ended December&nbsp;31, 2015 was impacted by changes in the components of accounts payable and accrued expenses, primarily
related to increases in incentive compensation, partially offset by improved operating results. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Investing Activities
</I></B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">During the year ended December&nbsp;31, 2017, our net cash used in investing activities of $576.6&nbsp;million
included acquisition payments of $531.7&nbsp;million, capital expenditures of $49.3&nbsp;million and net purchases of investments of $2.3&nbsp;million. Our acquisition payments were related to the purchase of 10 physician practices. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>Financing Activities </I></B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">During the year ended December&nbsp;31, 2017, our net cash provided from financing activities of $89.7&nbsp;million consisted primarily of net borrowings on our Credit Facility of $147.0&nbsp;million,
proceeds from the exercise of employee stock options and the issuance of common stock under our ESPP and our SPP of $23.3&nbsp;million, partially offset by the repurchase of $70.2&nbsp;million of our common stock and the payment of $5.4&nbsp;million
for contingent consideration liabilities. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Liquidity </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">On October&nbsp;30, 2017, we entered into the Credit Agreement which replaces our prior credit agreement. The Credit Agreement provides for a $2.0&nbsp;billion unsecured revolving credit facility and
includes a $37.5&nbsp;million <FONT STYLE="white-space:nowrap">sub-facility</FONT> for the issuance of letters of credit. The Credit Agreement matures on October&nbsp;31, 2022 and is guaranteed by substantially all of our subsidiaries and affiliated
professional associations and corporations. At our option, borrowings under the Credit Agreement will bear interest at (i)&nbsp;the alternate base rate (defined as the higher of (a)&nbsp;the prime rate, (b)&nbsp;the Federal Funds Rate plus 1/2 of
1.00% and (c)&nbsp;LIBOR for an interest period of one month plus 1.00%) plus an applicable margin rate ranging from 0.125% to 0.750% based on our consolidated leverage ratio or (ii)&nbsp;the LIBOR rate plus an applicable margin rate ranging from
1.125% to 1.750% based on our consolidated leverage ratio. The Credit Agreement also calls for other customary fees and charges, including an unused commitment fee ranging from 0.150% to 0.300% of the unused lending commitments, based on our
consolidated leverage ratio. The Credit Agreement contains customary covenants and restrictions, including covenants that require us to maintain a minimum interest charge ratio, not to exceed a specified consolidated leverage ratio and to comply
with laws, and restrictions on the ability to pay dividends and make certain other distributions, as specified therein. Failure to comply with these covenants would constitute an event of default under the Credit Agreement, notwithstanding the
ability of the company to meet its debt service obligations. The Credit Agreement also includes various customary remedies for the lenders following an event of default, including the acceleration of repayment of outstanding amounts under the Credit
Agreement. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">At December&nbsp;31, 2017, we had an outstanding principal balance of $1.1&nbsp;billion on our Credit Agreement.
We also had outstanding letters of credit of $0.2&nbsp;million that reduced the amount available on our Credit Agreement to $889.3&nbsp;million at December&nbsp;31, 2017. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">59 </FONT></P>



<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">At December&nbsp;31, 2017, we had an outstanding principal balance of $750.0&nbsp;million on
our 2023 Senior Notes. Our obligations under the 2023 Senior Notes are guaranteed on an unsecured senior basis by the same subsidiaries and affiliated professional contractors that guarantee the Credit Agreement. Interest on the 2023 Senior Notes
accrues at the rate of 5.25% per annum, or $39.4&nbsp;million, and is payable semi-annually in arrears on June&nbsp;1 and December 1. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The indenture under which the 2023 Senior Notes are issued, among other things, limits our ability to (1)&nbsp;incur liens and (2)&nbsp;enter into sale and lease-back transactions, and also limits our
ability to merge or dispose of all or substantially all of our assets, in all cases, subject to a number of customary exceptions. Although we are not required to make mandatory redemption or sinking fund payments with respect to the 2023 Senior
Notes, upon the occurrence of a change in control of MEDNAX, we may be required to repurchase the 2023 Senior Notes at a purchase price equal to 101% of the aggregate principal amount of the 2023 Senior Notes repurchased plus accrued and unpaid
interest. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">At December&nbsp;31, 2017, we believe we were in compliance, in all material respects, with the financial covenants
and other restrictions applicable to us under the Credit Agreement and the 2023 Senior Notes. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The exercise of employee stock
options and the purchase of common stock by employees participating in our ESPP and SPP generated cash proceeds of $23.3&nbsp;million, $22.0&nbsp;million and $20.1&nbsp;million for the years ended December&nbsp;31, 2017, 2016 and 2015, respectively.
Because stock option exercises and purchases under the ESPP and SPP are dependent on several factors, including the market price of our common stock, we cannot predict the timing and amount of any future proceeds. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We maintain professional liability insurance policies with third-party insurers, subject to self-insured retention, exclusions and other
restrictions. We self-insure our liabilities to pay self-insured retention amounts under our professional liability insurance coverage through a wholly owned captive insurance subsidiary. We record liabilities for self-insured amounts and claims
incurred but not reported based on an actuarial valuation using historical loss information, claim emergence patterns and various actuarial assumptions. Our total liability related to professional liability risks at December&nbsp;31, 2017 was
$250.2&nbsp;million, of which $37.9&nbsp;million is classified as a current liability within accounts payable and accrued expenses in the Consolidated Balance Sheet. In addition, there is a corresponding insurance receivable of $18.9&nbsp;million
recorded as a component of other assets for certain professional liability claims that are covered by insurance policies. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">We
anticipate that funds generated from operations, together with our current cash on hand and funds available under our Credit Agreement, will be sufficient to finance our working capital requirements, fund anticipated acquisitions and capital
expenditures, fund our share repurchase programs and meet our contractual obligations as described below for at least the next 12 months from the date of issuance of this Form <FONT STYLE="white-space:nowrap">10-K.</FONT> </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>CONTRACTUAL OBLIGATIONS </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">At December&nbsp;31, 2017, we had the following obligations and commitments (in thousands): </FONT></P>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="53%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="18" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Payments Due</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom" NOWRAP> <P STYLE="border-bottom:1px solid #000000;width:36pt ; display:inline;"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Obligation</B></FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Total</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2018</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2019</B></FONT><br><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>and 2020</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2021</B></FONT><br><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>and 2022</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2023</B></FONT><br><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>and Later</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Credit Agreement (1)</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,291,847</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">37,545</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">75,090</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,179,212</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2"> &#151;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2023 Senior Notes (1)</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">982,969</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">39,375</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">78,750</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">78,750</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">786,094</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Capital leases</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,826</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,401</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">351</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">74</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#151;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Operating leases</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">105,272</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">34,337</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">40,811</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">20,190</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">9,934</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,381,914</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">112,658</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">195,002</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,278,226</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">796,028</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">60 </FONT></P>



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<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">(1)</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Amounts include interest payments at the applicable rate as of December&nbsp;31, 2017 and assume the amount outstanding under our Credit Agreement as of
December&nbsp;31, 2017 will be paid on the maturity date and amounts outstanding under our 2023 Senior Notes will be paid on their maturity date of December&nbsp;1, 2023. </FONT></TD></TR></TABLE>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Certain of our acquisition agreements contain contingent consideration provisions based on volume and other performance measures over an
up to five-year period. Potential payments under these provisions are not contingent upon the future employment of the sellers. As of December&nbsp;31, 2017, cash payments of up to $32.2&nbsp;million may be due through 2020 under all contingent
consideration provisions as follows (in thousands): </FONT></P> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="68%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="88%"></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2018</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">6.4</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2019</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">24.5</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2020</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1.3</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">32.2</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">At December&nbsp;31, 2017, our total liability for uncertain tax positions was $12.1&nbsp;million, all of
which is included within other liabilities on our Consolidated Balance Sheets. The timing and amount of future cash flows for each year beyond 2017 cannot be reasonably estimated. See Note 11 to our Consolidated Financial Statements in this Form <FONT
STYLE="white-space:nowrap">10-K</FONT> for more information regarding our uncertain tax positions. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><FONT STYLE="white-space:nowrap">OFF-BALANCE</FONT> SHEET ARRANGEMENTS </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">At December&nbsp;31, 2017, we leased, under operating lease agreements, space in hospitals and other facilities for our business and medical offices, as well as certain equipment necessary for business
operations, which are included in the table above. We did not have any other <FONT STYLE="white-space:nowrap">off-balance</FONT> sheet arrangements that have or are reasonably likely to have a current or future effect on our financial condition,
changes in financial condition, revenue or expenses, results of operations, liquidity, capital expenditures or capital resources. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>RECENTLY
ADOPTED ACCOUNTING PRONOUNCEMENTS </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In January 2017, the accounting guidance related to goodwill impairment was amended to
remove step two of the impairment test that requires a hypothetical purchase price allocation in order to measure the amount of any impairment. Under the new guidance, only a single-step quantitative test is required and any goodwill impairment will
now be the amount by which a reporting unit&#146;s carrying value exceeds its fair value. The new guidance does not amend the optional alternative to perform a qualitative assessment to determine if a quantitative goodwill impairment test is
necessary. We early adopted this accounting guidance on December&nbsp;31, 2017 as permitted. The adoption of this guidance did not have an impact on our Consolidated Financial Statements. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In January 2017, the accounting guidance related to business combinations was amended to clarify the definition of a business. We early
adopted this accounting guidance on December&nbsp;31, 2017 as permitted. The adoption of this guidance did not have an impact on our Company&#146;s Consolidated Financial Statements. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In August 2016 and November 2016, the accounting guidance related to the statement of cash flows was amended with the intent of reducing
diversity in practice as to the classification of certain transactions in the statement of cash flows as well as to clarify the presentation of restricted cash in the Statement of Cash Flows. We early adopted this accounting guidance on
December&nbsp;31, 2017 as permitted. The adoption of this guidance resulted in the inclusion of restricted cash balances in our Consolidated Statements of Cash Flows. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">In March 2016, the accounting guidance related to various aspects of share-based payment transactions was amended, including income tax consequences, classification of awards as either equity or
liabilities, and classification on the statement of cash flows. Under the new guidance, excess tax benefits and deficiencies are to </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">61 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
be recognized as income tax benefits or expenses in the income statement as discrete items in the reporting period in which they occur instead of increases or decreases to shareholders&#146;
equity. Excess tax benefits should be classified along with other income tax cash flows as operating activities. With regard to forfeitures, the entity may make an entity-wide accounting policy election to either estimate the number of awards that
are expected to vest or account for forfeitures when they occur. This guidance became effective for us on January&nbsp;1, 2017. We adopted this guidance prospectively for both the income statement and statement of cash flows, and the adoption of
this guidance did not have a material impact on our Consolidated Financial Statements. We continue to estimate forfeitures based on the number of awards that are expected to vest. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>NEW ACCOUNTING PRONOUNCEMENTS </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In February 2016, accounting guidance
related to leases was issued that will require an entity to recognize leased assets and the rights and obligations created by those leased assets on the balance sheet and to disclose key information about the entity&#146;s leasing arrangements. This
guidance will become effective for us on January&nbsp;1, 2019, with early adoption permitted. We expect that the adoption of this guidance will have a material impact on our Consolidated Balance Sheets and related disclosures, resulting from the
recognition of significant right of use assets and related liabilities primarily related to our operating lease arrangements for space in hospitals and certain other facilities for our business and medical offices. We are in the process of reviewing
our existing lease portfolio and accumulating all of the necessary information required to properly account for leases under the new guidance.&nbsp;Additionally, we are assessing system requirements, required changes to our processes and internal
control implications to ensure we will meet the reporting and disclosure requirements. Our evaluation of this guidance and its impacts are expected to continue through the third quarter of 2018. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In May 2014, the accounting guidance related to revenue recognition was amended to outline a single, comprehensive model for accounting
for revenue from contracts with customers. The core principle of the new accounting guidance is to require an entity to recognize as revenue the amount that reflects the consideration to which it expects to be entitled in exchange for goods or
services as it transfers control to its customers.&nbsp;The new guidance will become effective for us on January&nbsp;1, 2018. Our current revenue recognition policies for our significant revenue streams materially comply with the amended guidance.
The primary change for healthcare providers under the new guidance is the requirement to report the allowance for uncollectibles associated with patient responsibility amounts as a reduction in net revenue as opposed to bad debt expense as a
component of operating expenses. The Company has historically included the allowance for uncollectibles associated with patient responsibility amounts with its allowance for contractual adjustments as a reduction in net revenue as such amounts are
not material. Accordingly, the adoption of this guidance will not have an impact on our Consolidated Financial Statements. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">62 </FONT></P>



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<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><A NAME="tx463027_10"></A>ITEM&nbsp;7A.</B></FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK </B></FONT></TD></TR></TABLE> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">We are subject to market risk primarily from exposure to changes in interest rates based on our financing, investing and cash management activities. We intend to manage interest rate risk through the use
of a combination of fixed rate and variable rate debt. We borrow under our Credit Agreement at various interest rate options based on the Alternate Base Rate or LIBOR rate depending on certain financial ratios. At December&nbsp;31, 2017, the
outstanding principal balance on our Credit Agreement was $1.1&nbsp;billion. Considering the total outstanding balance of $1.1&nbsp;billion, a 1% change in interest rates would result in an impact to income before income taxes of $11.1&nbsp;million
per year. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">63 </FONT></P>



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<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx463027_11"></A>ITEM&nbsp;8.</B></TD>
<TD ALIGN="left" VALIGN="top"><B>FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA </B></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following Consolidated Financial
Statements and Financial Statement Schedule of MEDNAX, Inc. and its subsidiaries are included in this Form <FONT STYLE="white-space:nowrap">10-K</FONT> on the pages set forth below: </P>
<P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>INDEX TO FINANCIAL STATEMENTS </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>AND FINANCIAL STATEMENT SCHEDULE </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="95%"></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Page</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><B>Consolidated Financial Statements</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_21">Report of Independent Registered Certified Public Accounting
Firm</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">65</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_22">Consolidated Balance Sheets at December&nbsp;31, 2017 and 2016</A></P></TD>

<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">67</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_23">Consolidated Statements of Income for the Years Ended December&nbsp;
31, 2017, 2016 and 2015</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">68</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_24">Consolidated Statements of Equity for the Years Ended December&nbsp;
31, 2017, 2016 and 2015</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">69</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_25">Consolidated Statements of Cash Flows for the Years Ended December&nbsp;
31, 2017, 2016 and 2015</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">70</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_26">Notes to Consolidated Financial Statements</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">71</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><B>Financial Statement Schedule</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx463027_27">Schedule II&#151;Valuation and Qualifying Accounts for the Years Ended December&nbsp;31,
 2017, 2016 and 2015&nbsp;</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">98</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
</TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">64 </P>


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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx463027_21"></A>Report of Independent Registered Public Accounting Firm </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">To the<B> </B>Board of Directors and shareholders of </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">MEDNAX,
Inc. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Opinions on the Financial Statements and Internal Control over Financial Reporting </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">We have audited the accompanying consolidated balance sheets of MEDNAX, Inc. and its subsidiaries as of December&nbsp;31, 2017 and December&nbsp;31, 2016, and
the related consolidated statements of income, consolidated statements of equity, statements of cash flow for each of the three years in the period ended December&nbsp;31, 2017, including the related notes<B> </B>and financial statement schedule
listed in the accompanying index (collectively referred to as the &#147;consolidated financial statements&#148;).<B> </B>We also have audited the Company&#146;s internal control over financial reporting as of December&nbsp;31, 2017, based on
criteria established in <I>Internal Control&#151;Integrated Framework</I> (2013)&nbsp;issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">In our opinion, the consolidated<B> </B>financial statements referred to above present fairly, in all material respects, the financial position of the Company
as of December&nbsp;31, 2017 and December&nbsp;31, 2016, and the results of<B> </B>their operations and their cash flows for each of the three years in the period ended<B> </B>December&nbsp;31, 2017,<B> </B>in conformity with accounting principles
generally accepted in the United States of America. Also in our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December&nbsp;31, 2017, based on criteria established in <I>Internal
Control&#151;Integrated Framework</I> (2013)&nbsp;issued by the COSO. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Basis for Opinions </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The Company&#146;s management is responsible for these consolidated financial statements, for maintaining effective internal control over financial reporting,
and for its assessment of the effectiveness of internal control over financial reporting, included in Management&#146;s Annual Report on Internal Control over Financial Reporting under Item 9A. Our responsibility is to express opinions on the
Company&#146;s consolidated<B> </B>financial statements and on the Company&#146;s internal control over financial reporting based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United
States) (&#147;PCAOB&#148;) and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audits to obtain reasonable
assurance about whether the consolidated<B> </B>financial statements are free of material misstatement, whether due to error or fraud, and whether effective internal control over financial reporting was maintained in all material respects. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Our audits of the consolidated financial statements included performing procedures to assess the risks of material misstatement of the consolidated financial
statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our
audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. Our audit of internal control over financial
reporting included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, and testing and evaluating the design and operating effectiveness of internal control based on the
assessed risk. Our audits also included performing such other procedures as we considered necessary in the circumstances. We believe that our audits provide a reasonable basis for our opinions. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">As described in Management&#146;s Annual Report on Internal Control over Financial Reporting, management has excluded four radiology physician practices from
its assessment of internal control over financial reporting as of December&nbsp;31, 2017 because they were acquired by the Company in purchase business combinations during 2017. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">65 </P>


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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
We have also excluded these four radiology physician practices from our audit of internal control over financial reporting. These four radiology physician practices are subsidiaries whose
aggregate total assets and aggregate net revenues excluded from management&#146;s assessment and our audit of internal control over financial reporting collectively represent approximately 2% and 3%, respectively, of the related consolidated
financial statement amounts as of and for the year ended December&nbsp;31, 2017. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Definition and Limitations of Internal Control over Financial
Reporting </I></B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">A company&#146;s internal control over financial reporting is a process designed to provide reasonable assurance regarding the
reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company&#146;s internal control over financial reporting includes those policies and
procedures that (i)&nbsp;pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (ii)&nbsp;provide reasonable assurance that transactions are
recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management
and directors of the company; and (iii)&nbsp;provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company&#146;s assets that could have a material effect on the financial
statements. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of
any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">/s/ PricewaterhouseCoopers LLP </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Certified Public Accountants
</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Miami, Florida </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">February&nbsp;14, 2018 </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">We have served as the Company&#146;s auditor since 1999.<SUP STYLE="font-size:85%; vertical-align:top"> </SUP> </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">66 </P>


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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx463027_22"></A>CONSOLIDATED BALANCE SHEETS </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(in thousands) </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="78%"></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2017</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" ALIGN="center"><B>ASSETS</B></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Current assets:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Cash and cash equivalents</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">60,200</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">55,698</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Short-term investments</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">10,292</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">11,286</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Accounts receivable, net</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">503,999</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">495,276</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Prepaid expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">15,584</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">11,051</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Other assets</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">37,160</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">13,817</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total current assets</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">627,235</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">587,128</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Restricted cash</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">20,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Investments</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">80,682</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">78,975</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Property and equipment, net</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">123,536</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">103,068</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Goodwill</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,283,963</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,845,157</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Intangible assets, net</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">639,928</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">668,529</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Other assets</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">91,934</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">56,543</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total assets</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">5,867,278</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">5,339,400</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" ALIGN="center"><B>LIABILITIES&nbsp;&amp; SHAREHOLDERS&#146; EQUITY</B></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Current liabilities:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Accounts payable and accrued expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">438,017</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">407,938</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Current portion of long-term debt and capital lease obligations</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,401</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">22,054</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income taxes payable</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,007</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">18,957</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total current liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">531,425</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">448,949</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Line of credit</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,110,500</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">783,500</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Long-term debt and capital lease obligations, net</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">740,923</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">900,128</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Long-term professional liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">212,274</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">173,080</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Deferred income taxes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">147,797</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">227,802</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Other liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">57,905</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">45,174</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,800,824</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,578,633</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Commitments and contingencies</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Shareholders&#146; equity:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Preferred stock; $.01 par value; 1,000 shares authorized; none issued</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Common stock; $.01 par value; 200,000 shares authorized; 93,721 and 93,718 shares issued and
outstanding, respectively</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">937</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">937</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Additional <FONT STYLE="white-space:nowrap">paid-in</FONT> capital</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,017,328</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">974,304</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Retained earnings</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,048,189</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,785,526</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total shareholders&#146; equity</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,066,454</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,760,767</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total liabilities and shareholders&#146; equity</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">5,867,278</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">5,339,400</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:70pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><I>The accompanying notes are an integral part of these Consolidated Financial Statements. </I></P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">67 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx463027_23"></A>CONSOLIDATED STATEMENTS OF INCOME </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(in thousands, except for per share data) </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="67%"></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2017</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2015</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net revenue</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3,458,312</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3,183,159</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,779,996</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Operating expenses:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Practice salaries and benefits</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,337,734</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,031,220</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,753,505</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Practice supplies and other operating expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">120,518</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">118,416</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">98,480</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">General and administrative expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">417,105</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">372,572</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">305,915</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Depreciation and amortization</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">102,879</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">89,264</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">64,228</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total operating expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,978,236</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,611,472</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,222,128</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income from operations</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">480,076</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">571,687</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">557,868</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Investment and other income</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,953</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,019</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,844</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Interest expense</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(74,559</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(63,092</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(23,110</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Equity in earnings of unconsolidated affiliates</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">952</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,185</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,127</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total <FONT STYLE="white-space:nowrap">non-operating</FONT> expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(69,654</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(57,888</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(18,139</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income before income taxes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">410,422</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">513,799</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">539,729</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income tax provision</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(90,050</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(189,203</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(204,038</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">320,372</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">324,596</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">335,691</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net loss attributable to noncontrolling interests</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">318</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">629</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income attributable to MEDNAX, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">320,372</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">324,914</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">336,320</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Per common and common equivalent share data:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income attributable to MEDNAX, Inc.:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Basic</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3.47</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3.52</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3.61</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Diluted</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3.45</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3.49</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3.58</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Weighted average common shares:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Basic</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,431</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,422</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,077</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Diluted</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,958</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,109</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,960</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="font-size:80pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P> <P STYLE="margin-top:80pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><I>The accompanying notes are an integral
part of these Consolidated Financial Statements. </I></P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">68 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx463027_24"></A>CONSOLIDATED STATEMENTS OF EQUITY </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(in thousands) </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
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<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
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<TD></TD>
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<TD></TD>
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<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Common Stock</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD COLSPAN="2" VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD COLSPAN="2" VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD COLSPAN="2" VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD COLSPAN="2" VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Number&nbsp;of<BR>Shares</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Amount</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Additional</B><br><B><FONT STYLE="white-space:nowrap">Paid-in</FONT><BR>Capital</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Retained<BR>Earnings</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Noncontrolling<BR>Interests</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Total Equity</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at December&nbsp;31, 2014</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">96,030</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">960</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">886,877</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,376,782</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">947</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,265,566</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income (loss)</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">336,320</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(629</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">335,691</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Common stock issued under employee stock option and employee stock purchase plan</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">463</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">20,123</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">20,128</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Issuance of restricted stock and vesting of deferred stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">527</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(5</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Issuance of restricted stock for acquisition consideration</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">114</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">7,799</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">7,800</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Stock-based compensation expense</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">32,129</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">32,129</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Forfeitures of restricted stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(30</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Repurchased common stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(3,365</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(34</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(32,271</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(202,746</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(235,051</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Excess tax benefit related to employee stock incentive plans</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">11,583</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">11,583</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at December&nbsp;31, 2015</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,739</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">937</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">926,235</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,510,356</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">318</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,437,846</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income (loss)</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">324,914</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(318</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">324,596</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Common stock issued under employee stock option, employee stock purchase plan and stock purchase
plan</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">473</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">22,017</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">22,022</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Issuance of restricted stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">505</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(5</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Stock-based compensation expense</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">34,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">34,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Forfeitures of restricted stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(53</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Repurchased common stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(946</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(9</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(12,075</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(49,744</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(61,828</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Excess tax benefit related to employee stock incentive plans</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,131</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,131</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at December&nbsp;31, 2016</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,718</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">937</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">974,304</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,785,526</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,760,767</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">320,372</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">320,372</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Common stock issued under employee stock option, employee stock purchase plan and stock purchase
plan</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">528</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">23,271</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">23,276</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Issuance of restricted stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">536</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(5</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Issuance of restricted stock for acquisition consideration</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">69</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,657</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,658</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Stock-based compensation expense</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">29,573</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">29,573</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Forfeitures of restricted stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(92</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Repurchased common stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1,038</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(10</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(12,473</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(57,709</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(70,192</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at December&nbsp;31, 2017</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,721</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">937</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,017,328</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,048,189</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3,066,454</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:75pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><I>The accompanying notes are an integral part of these Consolidated Financial Statements. </I></P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">69 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx463027_25"></A>CONSOLIDATED STATEMENTS OF CASH FLOWS </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(in thousands) </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:9pt" ALIGN="center">


<TR>
<TD WIDTH="67%"></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2017</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2015</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Cash flows from operating activities:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Net income</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">320,372</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">324,596</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">335,691</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Adjustments to reconcile net income to net cash provided from operating activities:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Depreciation and amortization</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">102,879</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">89,264</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">64,228</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Amortization of premiums, discounts and issuance costs</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5,514</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,816</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,541</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Stock-based compensation expense</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">29,573</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">34,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">32,129</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Deferred income taxes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(60,073</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">18,149</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">14,494</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Other</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(3,783</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">212</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1,052</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Changes in assets and liabilities:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Accounts receivable</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">7,803</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(34,000</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(55,391</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Prepaid expenses and other current assets</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,792</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(783</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(4,905</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Other long-term assets</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,709</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">10,035</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">98</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Accounts payable and accrued expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">24,551</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">11,617</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(7,874</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Income taxes payable</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">73,050</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,234</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(4,101</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Payments of contingent consideration liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(750</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1,037</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1,439</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Long-term professional liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">18,478</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(3,452</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,064</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Other liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(735</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(7,405</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,654</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Net cash provided from operating activities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">511,378</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">443,778</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">368,701</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Cash flows from investing activities:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Acquisition payments, net of cash acquired</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(531,696</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(762,302</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(818,903</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Purchases of investments</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(27,723</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(60,976</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(33,980</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Proceeds from maturities of investments</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">25,410</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">41,325</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">31,956</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Purchases of property and equipment</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(49,309</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(39,264</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(27,073</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Other</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6,705</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Net cash used in investing activities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(576,613</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(821,217</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(848,000</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Cash flows from financing activities:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Borrowings on credit agreement</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,846,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,940,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,121,500</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Payments on credit agreement</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,699,000</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1,510,000</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,156,000</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Proceeds from issuance of senior notes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">750,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Payments for financing costs</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(3,525</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(14,190</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Payments of contingent consideration liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(5,449</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(10,740</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(12,856</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Payments on capital lease obligations</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,267</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,130</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,171</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Excess tax benefit from exercises of stock options and vesting of restricted and deferred
stock</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,241</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">11,583</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Proceeds from issuance of common stock</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">23,276</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">22,022</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">20,128</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Contribution from noncontrolling interests</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">894</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Repurchases of common stock</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(70,192</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(61,828</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(235,051</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Net cash provided from financing activities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">89,737</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">381,565</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">482,943</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Net increase in cash and cash equivalents</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">24,502</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,126</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,644</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Cash, cash equivalents and restricted cash at beginning of year</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">55,698</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">51,572</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">47,928</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Cash, cash equivalents and restricted cash at end of year</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">80,200</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">55,698</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">51,572</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Supplemental disclosure of cash flow information:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Cash paid for:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:6.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Interest</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">73,837</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">60,453</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">20,367</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:6.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Income taxes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">75,427</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">175,962</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">181,005</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman"><FONT STYLE="white-space:nowrap">Non-cash</FONT> investing and financing activities:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:6.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Value of common stock issued for acquisitions</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,657</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">7,800</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:6.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Equipment financed through capital leases</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">684</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,619</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3,135</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:6.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Property and equipment included in accounts payable</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,700</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,673</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,800</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><I>The accompanying notes are an integral part of these Consolidated Financial Statements. </I></P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">70 </P>


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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx463027_26"></A>NOTES TO CONSOLIDATED FINANCIAL STATEMENTS </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>1.&nbsp;&nbsp;&nbsp;&nbsp;General: </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The
principal business activity of MEDNAX, Inc. (&#147;MEDNAX&#148; or the &#147;Company&#148;) and its subsidiaries is to provide neonatal, anesthesia, radiology and teleradiology, maternal-fetal and other pediatric subspecialty physician services. The
Company has contracts with affiliated business corporations or professional associations, limited liability companies and partnerships (&#147;affiliated professional contractors&#148;), which are separate legal entities that provide physician
services in certain states and Puerto Rico. The Company and its affiliated professional contractors also have contracts with hospitals and other healthcare facilities to provide physician services, which include <FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap">(i)&nbsp;fee-for-service</FONT></FONT> contracts, whereby hospitals and other customers agree, in exchange for the Company&#146;s services, to authorize the Company and its healthcare professionals to bill and collect the
charges for medical services rendered by the Company&#146;s affiliated healthcare professionals, and (ii)&nbsp;administrative fee contracts, whereby the Company is assured a minimum revenue level. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition to its national physician network, the Company also provides services nationwide to healthcare providers, including its own,
through complementary businesses including a management services organization specializing in full-service revenue cycle management and a consulting services company. </P> <P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><B>2.&nbsp;&nbsp;&nbsp;&nbsp;Summary</B></TD>
<TD ALIGN="left" VALIGN="top"><B>of Significant Accounting Policies: </B></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Principles of Presentation </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The consolidated financial statements include all the accounts of the Company and its subsidiaries combined with the accounts of the affiliated
professional contractors with which the Company currently has specific management arrangements. The Company&#146;s agreements with affiliated professional contractors provide that the term of the arrangements are in most cases permanent, subject
only to termination by the Company, except in the case of gross negligence, fraud or bankruptcy of the Company. The Company has the right to receive income, both as ongoing fees and as proceeds from the sale of its interest in the Company&#146;s
affiliated professional contractors, in an amount that fluctuates based on the performance of the affiliated professional contractors and the change in the fair value of the Company&#146;s interest in the affiliated professional contractors. The
Company has exclusive responsibility for the provision of all <FONT STYLE="white-space:nowrap">non-medical</FONT> services required for the <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">day-to-day</FONT></FONT> operation and
management of the Company&#146;s affiliated professional contractors and establishes the guidelines for the employment and compensation of the physicians. In addition, the agreements provide that the Company has the right, but not the obligation, to
purchase, or to designate a person(s) to purchase, the stock of the Company&#146;s affiliated professional contractors for a nominal amount. Separately, in its sole discretion, the Company has the right to assign its interest in the agreements.
Based upon the provisions of these agreements, the Company has determined that the affiliated professional contractors are variable interest entities and that the Company is the primary beneficiary as defined in the accounting guidance for
consolidation. All significant intercompany and interaffiliate accounts and transactions have been eliminated. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company is a partner
in a joint venture in which it owns a 37.5% economic interest. The Company accounts for this joint venture under the equity method of accounting because the Company exercises significant influence over, but does not control, this entity. On
March&nbsp;31, 2017, the Company sold its 75% economic interest in a second joint venture. The Company had a management agreement with the joint venture and, based on the terms of the agreement, the Company had determined that the joint venture was
a variable interest entity for which the Company was the primary beneficiary. Accordingly, through the date of the sale, the financial results of the joint venture were fully consolidated into the Company&#146;s operating results and the equity
interests of the outside investor in the equity and results of operations of this consolidated entity were accounted for and presented as noncontrolling interests. See Note 6 for more information regarding the deconsolidation of this joint venture.
</P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">71 </P>


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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Recently Adopted Accounting Pronouncements </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In January 2017, the accounting guidance related to goodwill impairment was amended to remove step two of the impairment test that
requires a hypothetical purchase price allocation in order to measure the amount of any impairment. Under the new guidance, only a single-step quantitative test is required and any goodwill impairment will now be the amount by which a reporting
unit&#146;s carrying value exceeds its fair value. The new guidance does not amend the optional alternative to perform a qualitative assessment to determine if a quantitative goodwill impairment test is necessary. The Company early adopted this
accounting guidance on December&nbsp;31, 2017 as permitted. The adoption of this guidance did not have an impact on the Company&#146;s Consolidated Financial Statements. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">In January 2017, the accounting guidance related to business combinations was amended to clarify the definition of a business. The Company early adopted this accounting guidance on December&nbsp;31, 2017
as permitted. The adoption of this guidance did not have an impact on the Company&#146;s Consolidated Financial Statements. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In August 2016 and November 2016, the accounting guidance related to the statement of cash flows was amended with the intent of reducing
diversity in practice as to the classification of certain transactions in the statement of cash flows. The Company early adopted this accounting guidance on December&nbsp;31, 2017 as permitted. The adoption of this guidance resulted in the inclusion
of restricted cash balances in the Company&#146;s Consolidated Statements of Cash Flows. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In March 2016, the accounting
guidance related to various aspects of share-based payment transactions was amended, including income tax consequences, classification of awards as either equity or liabilities, and classification on the statement of cash flows. Under the new
guidance, excess tax benefits and deficiencies are to be recognized as income tax benefits or expenses in the income statement as discrete items in the reporting period in which they occur instead of increases or decreases to shareholders&#146;
equity. Excess tax benefits should be classified along with other income tax cash flows as operating activities. With regard to forfeitures, the entity may make an entity-wide accounting policy election to either estimate the number of awards that
are expected to vest or account for forfeitures when they occur. This guidance became effective for the Company on January&nbsp;1, 2017. The Company adopted this guidance prospectively for both the income statement and statement of cash flows, and
the adoption of this guidance did not have a material impact on the Company&#146;s Consolidated Financial Statements. The Company continues to estimate forfeitures based on the number of awards that are expected to vest. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>New Accounting Pronouncements </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">In February 2016, the accounting guidance related to leases was issued that will require an entity to recognize leased assets and the rights and obligations created by those leased assets on the balance
sheet and to disclose key information about the entity&#146;s leasing arrangements. This guidance will become effective for the Company on January&nbsp;1, 2019, with early adoption permitted. The Company expects that the adoption of this guidance
will have a material impact on its Consolidated Balance Sheets and related disclosures, resulting from the recognition of significant right of use assets and related liabilities primarily related to its operating lease arrangements for space in
hospitals and certain other facilities for its business and medical offices. The Company is in the process of reviewing its existing lease portfolio and accumulating all of the necessary information required to properly account for leases under the
new guidance.&nbsp;Additionally, the Company is assessing system requirements, required changes to its processes and internal control implications to ensure the Company will meet the reporting and disclosure requirements. The Company&#146;s
evaluation of this guidance and its impacts are expected to continue through the third quarter of 2018. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In May 2014, the
accounting guidance related to revenue recognition was amended to outline a single, comprehensive model for accounting for revenue from contracts with customers. The core principle of the new </FONT></P>

 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">72 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
accounting guidance is to require an entity to recognize as revenue the amount that reflects the consideration to which it expects to be entitled in exchange for goods or services as it transfers
control to its customers.&nbsp;The new guidance will become effective for the Company on January&nbsp;1, 2018. The Company&#146;s current revenue recognition policies for its significant revenue streams materially comply with the amended guidance.
The primary change for healthcare providers under the new guidance is the requirement to report the allowance for uncollectibles associated with patient responsibility amounts as a reduction in net revenue as opposed to bad debt expense as a
component of operating expenses. The Company has historically included the allowance for uncollectibles associated with patient responsibility amounts with its allowance for contractual adjustments as a reduction in net revenue as such amounts are
not material. Accordingly, the adoption of this guidance will not have an impact on our Consolidated Financial Statements. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Accounting
Estimates and Assumptions </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The preparation of financial statements in conformity with accounting principles generally
accepted in the United States (&#147;GAAP&#148;) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial
statements and the reported amounts of revenue and expenses during the reporting periods. Significant estimates and assumptions are involved in the calculation of the Company&#146;s allowance for contractual adjustments and uncollectibles on
accounts receivable, liabilities for self- insured amounts and claims incurred but not reported related to the Company&#146;s professional liability risks and the fair value of goodwill. Actual results could differ from those estimates. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Segment Reporting </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The
results of the Company&#146;s operations are aggregated into a single reportable segment for purposes of presenting financial information in accordance with the accounting guidance for segment reporting. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The following table summarizes the Company&#146;s net revenue by service line (in percentages): </FONT></P>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="75%"></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Years&nbsp;Ended&nbsp;December&nbsp;31,</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2017</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2016</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2015</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Anesthesiology</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">38</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">39</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">37</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Neonatology and other pediatric subspecialties</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">37</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">39</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">44</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Maternal-fetal medicine</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">8</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">8</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">9</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Radiology and teleradiology</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">8</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">6</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">4</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Management services</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">6</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">5</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Pediatric cardiology</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">4</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">100</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">100</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">100</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">%&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Revenue Recognition </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Patient service revenue is recognized at the time services are provided by the Company&#146;s affiliated physicians. Almost all of the Company&#146;s patient service revenue is reimbursed by
government-sponsored healthcare programs and third-party insurance payors. Payments for services rendered to the Company&#146;s patients are generally less than billed charges. The Company monitors its revenue and receivables from these sources and
records an estimated contractual allowance to properly account for the anticipated differences between billed and reimbursed amounts. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Accordingly, patient service revenue is presented net of an estimated provision for contractual adjustments and uncollectibles. The Company estimates allowances for contractual adjustments and
uncollectibles on accounts receivable based upon historical experience and other factors, including days sales outstanding (&#147;DSO&#148;) </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">73 </FONT></P>



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for accounts receivable, evaluation of expected adjustments and delinquency rates, past adjustments and collection experience in relation to amounts billed, an aging of accounts receivable,
current contract and reimbursement terms, changes in payor mix and other relevant information. Contractual adjustments result from the difference between the physician rates for services performed and the reimbursements by government-sponsored
healthcare programs and insurance companies for such services. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In addition, the Company generates revenue for services
rendered under various coding and billing contracts. Contract terms are specific to each customer and may include a combination of a flat fee for coding of medical charts, a fixed fee per patient visit as well as a percentage of cash collections
received by the providers. Revenue for flat and fixed fee arrangements is recognized in the month the coding occurs or the patient visit occurs. Revenue for percentage fees are recognized in the month that cash is collected for customers from
payors. Revenue recorded for these services during 2017 were immaterial. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Accounts receivable are primarily amounts due under <FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">fee-for-service</FONT></FONT> contracts from third-party payors, such as insurance companies, self-insured employers and patients and government-sponsored healthcare programs geographically
dispersed throughout the United States and its territories. Concentration of credit risk relating to accounts receivable is limited by the number, diversity and geographic dispersion of the business units managed by the Company, as well as by the
large number of patients and payors, including the various governmental agencies in the states in which the Company provides services. Receivables from government agencies made up approximately 17% of net accounts receivable at December&nbsp;31,
2017 and 2016. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Cash and Cash Equivalents </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Cash equivalents are defined as all highly liquid financial instruments with maturities of 90 days or less from the date of purchase. The Company&#146;s cash equivalents typically consist of demand
deposits, amounts on deposit in money market accounts, and funds invested in overnight repurchase agreements. Cash equivalent balances may, at certain times, exceed federally insured limits. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Certain cash equivalents carried by the Company are subject to the fair value provisions of the accounting guidance for fair value
measurements. See &#147;Fair Value Measurements&#148; below. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Restricted Cash </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Restricted cash consists of funds in escrow related to a potential future payment for contingent consideration for an acquisition
completed during the year ended December&nbsp;31, 2017. See Note 6 for more information regarding the underlying contingent consideration arrangement. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Investments </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Investments consist of municipal debt securities, federal home
loan securities and certificates of deposit. Investments with remaining maturities of less than one year are classified as short-term investments. Investments classified as long-term have maturities of one year to six years. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company intends and has the ability to hold its securities to maturity, and therefore carries such investments at amortized cost in
accordance with the provisions of the accounting guidance for investments in debt securities. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Property and Equipment </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Property and equipment are recorded at original purchase cost. Depreciation of property and equipment is computed using the straight-line
method over the estimated useful lives of the underlying assets. Estimated useful lives are generally 30 years for buildings; three to seven years for medical equipment, computer equipment, </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">74 </FONT></P>



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software and furniture; and the lesser of the useful life or the remaining lease term for leasehold improvements and capital leases. Upon sale or retirement of property and equipment, the related
cost and accumulated depreciation are eliminated from the respective accounts and any resulting gain or loss is included in earnings. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Business Acquisitions </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company accounts for all business acquisitions at fair value and expenses acquisition costs as they are incurred. Any identifiable
assets acquired and liabilities assumed are recognized and measured at their respective fair values on the acquisition date. If information about facts and circumstances existing as of the acquisition date is incomplete at the end of the reporting
period in which a business acquisition occurs, the Company will report provisional amounts for the items for which the accounting is incomplete. The measurement period ends once the Company receives sufficient information to finalize the fair
values; however, the period will not exceed one year from the acquisition date. Prior to January&nbsp;1, 2016, any material adjustments recognized during the measurement period were required to be reflected retrospectively in the Consolidated
Financial Statements of the subsequent period. Beginning on January&nbsp;1, 2016, any adjustments to provisional amounts that are identified during the measurement period are required to be recognized in the reporting period in which the adjustment
amounts are determined. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In connection with certain acquisitions, the Company enters into agreements to pay additional amounts
in cash or common stock based on the achievement of certain performance measures for up to five years ending after the acquisition dates. The Company measures this contingent consideration at fair value at the acquisition date and records such
contingent consideration as a liability or equity on the Company&#146;s Consolidated Balance Sheets on the acquisition date. The fair value of each contingent consideration liability is remeasured at each reporting period with any change in fair
value recognized as income or expense within operations in the Company&#146;s Consolidated Statements of Income. See Note 6 for more information on the Company&#146;s business acquisitions. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Goodwill and Other Intangible Assets </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company records acquired assets
and assumed liabilities at their respective fair values under the acquisition method of accounting. Goodwill represents the excess of purchase price over the fair value of the net assets acquired. Intangible assets with finite lives, principally
physician and hospital agreements, customer relationships, patented technology and trade names, are recognized apart from goodwill at the time of acquisition based on the contractual-legal and separability criteria established in the accounting
guidance. Intangible assets with finite lives are amortized on either an accelerated basis based on the annual undiscounted economic cash flows associated with the particular intangible asset or on a straight-line basis over their estimated useful
lives. Intangible assets with finite lives are amortized over periods of one to 20 years. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Goodwill is tested for impairment
at a reporting unit level on at least an annual basis in accordance with the subsequent measurement provisions of the accounting guidance for goodwill. The Company defines a reporting unit based upon its management structure for services provided in
specific regions of the United States. The Company early adopted new accounting guidance in 2017 that requires only a single-step quantitative test with any goodwill impairment measured as the amount by which a reporting unit&#146;s carrying value
exceeds its fair value. The Company uses income and market-based valuation approaches to determine the fair value of its reporting units. These approaches focus on discounted cash flows and market multiples based on the Company&#146;s market
capitalization to derive the fair value of a reporting unit. The Company also considers the economic outlook for the healthcare services industry and various other factors during the testing process, including hospital and physician contract
changes, local market developments, changes in third-party payor payments, and other publicly available information. The Company completed annual impairment tests in the third quarter of each of 2017, 2016 and 2015 and determined that goodwill was
not impaired in any of the three years. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">75 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Long-Lived Assets </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The Company is required to evaluate long-lived assets, including intangible assets subject to amortization, whenever events or changes in circumstances indicate that the carrying value of the assets may
not be fully recoverable. The recoverability of such assets is measured by a comparison of the carrying value of the assets to the future undiscounted cash flows before interest charges to be generated by the assets. If long-lived assets are
impaired, the impairment to be recognized is measured as the excess of the carrying value over the fair value. Long-lived assets held for disposal are reported at the lower of the carrying value or fair value less disposal costs. The Company does
not believe there are any indicators that would require an adjustment to such assets or their estimated periods of recovery at December&nbsp;31, 2017 pursuant to current accounting standards. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Common Stock Repurchases </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company repurchases shares of its common
stock as authorized from time to time by its Board of Directors. The Company treats repurchased shares of its common stock as retired as any repurchased shares become authorized but unissued shares. The reacquisition cost of repurchased shares is
recorded as a reduction in the respective components of shareholders&#146; equity. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Professional Liability Coverage </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company maintains professional liability insurance policies with third-party insurers generally on a claims-made basis, subject to
deductibles or self-insured retention, exclusions and other restrictions. The Company&#146;s self-insured retention under its professional liability insurance program is maintained primarily through a wholly owned captive insurance subsidiary. The
Company records an estimate of liabilities for self-insured amounts and claims incurred but not reported based on an actuarial valuation using historical loss information, claim emergence patterns and various actuarial assumptions. Liabilities for
claims incurred but not reported are not discounted. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Income Taxes </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company records deferred income taxes using the liability method, whereby deferred tax assets and liabilities are determined based on
the difference between the financial statement and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. If it is more likely than not that all or a portion of deferred
tax assets will not be realized, a valuation allowance is provided against such deferred tax assets. In making such determination, the Company considers all available positive and negative evidence, including future reversals of existing taxable
temporary differences, projected future taxable income, <FONT STYLE="white-space:nowrap">tax-planning</FONT> strategies, and results of recent operations. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The accounting guidance for uncertain tax positions prescribes a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to
be taken in a tax return. The guidance also requires policy disclosures regarding penalties and interest and extensive disclosures regarding increases and decreases in uncertain tax positions as a result of tax positions taken in a current or prior
period, settlements with taxing authorities and any lapse of an applicable statute of limitations. Additional qualitative discussion is required for any tax position that may result in a significant increase or decrease in uncertain tax positions
within a <FONT STYLE="white-space:nowrap">12-month</FONT> period from the Company&#146;s reporting date. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Stock Incentive Plans
</B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company grants stock-based awards consisting primarily of restricted stock to key employees under its Amended and
Restated 2008 Incentive Compensation Plan, as amended. The Company measures the cost of employee services received in exchange for stock-based awards based on grant-date fair value and allocates the resulting compensation expense over the
corresponding requisite service period using the graded vesting attribution method. The Company also performs analyses to estimate forfeitures of stock-based awards on an annual basis and adjusts the estimates as necessary based on the number of
awards that ultimately vest. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">76 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Net Income Per Common Share </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the period. Diluted net income per common share is calculated by
dividing net income by the weighted average number of common and potential common shares outstanding during the period. Potential common shares consist of outstanding restricted stock, deferred stock and stock options and is calculated using the
treasury stock method. On January&nbsp;1, 2017, the Company adopted new accounting guidance that no longer permits the Company to include the assumed excess tax benefits related to the potential exercise or vesting of its stock-based awards in the
treasury stock method computation. The impact on the weighted average number of common and common equivalent shares outstanding from excluding such assumed excess tax benefits for the year ended December&nbsp;31, 2017 was not material. See
&#147;Recently Adopted Accounting Pronouncements&#148; above for additional information on the adoption of the new accounting guidance. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Fair Value Measurements </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In accordance with the accounting guidance for fair value measurements and disclosures, the Company carries its money market funds
included in cash and cash equivalents at fair value. In accordance with the three-tier fair value hierarchy under this guidance, the Company determined the fair value using quoted market prices, a Level&nbsp;1 input as defined under the accounting
guidance for fair value measurements. At December&nbsp;31, 2017 and 2016, the Company&#146;s money market funds had a fair value of $9.2&nbsp;million and $12.4&nbsp;million, respectively. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company also carries the cash surrender value of life insurance related to its deferred compensation arrangements at fair value. The
investments underlying the life insurance contracts consist primarily of exchange-traded equity securities and mutual funds with quoted prices in active markets. In accordance with the three-tier fair value hierarchy, the Company determined the fair
value using the cash surrender value of the life insurance, a Level&nbsp;2 input as defined under the accounting guidance for fair value measurements. At December&nbsp;31, 2017 and 2016, the Company&#146;s cash surrender value of life insurance had
a fair value of $15.6&nbsp;million and $15.8&nbsp;million, respectively. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In addition, the Company carries its contingent
consideration liabilities related to acquisitions at fair value. In accordance with the three-tier fair value hierarchy, the Company determined the fair value of its contingent consideration liabilities using the income approach with assumed
discount rates and payment probabilities. The income approach uses Level&nbsp;3, or unobservable inputs as defined under the accounting guidance for fair value measurements. At December&nbsp;31, 2017 and 2016, the Company&#146;s contingent
consideration liabilities had a fair value of $30.5&nbsp;million and $17.3&nbsp;million, respectively. See Note 6 for more information regarding the Company&#146;s contingent consideration liabilities. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The carrying amounts of cash equivalents, short-term investments, accounts receivable and accounts payable and accrued expenses
approximate fair value due to the short maturities of the respective instruments. The carrying values of long-term investments, line of credit, variable rate long-term debt and capital lease obligations approximate fair value. If the Company&#146;s
investments were measured at fair value, they would be categorized as Level&nbsp;2 in the fair value hierarchy. If the Company&#146;s line of credit and variable long-term debt were measured at fair value, they would be categorized as Level&nbsp;2
in the fair value hierarchy. See Note 10 for information regarding the fair value of the Company&#146;s 5.25% senior unsecured notes due 2023 (the &#147;2023 Notes&#148;). </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">77 </FONT></P>



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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>3.&nbsp;&nbsp;&nbsp;&nbsp;Investments: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Investments held are summarized as follows (in thousands): </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="92%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="52%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31, 2017</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31, 2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B><FONT STYLE="white-space:nowrap">Short-Term</FONT></B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B><FONT STYLE="white-space:nowrap">Long-Term</FONT></B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B><FONT STYLE="white-space:nowrap">Short-Term</FONT></B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B><FONT STYLE="white-space:nowrap">Long-Term</FONT></B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Municipal debt securities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">8,312</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">46,195</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">10,306</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">46,513</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Federal home loan securities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">30,322</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">28,747</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Certificates of deposit</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">980</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,165</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">980</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,715</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">10,292</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">80,682</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">11,286</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">78,975</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Contractual maturities of long-term investments are summarized as follows (in thousands): </P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="76%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="74%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2017</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Due after one year through five years</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">78,561</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">70,005</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Due after five years through six years</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,121</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">8,970</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">80,682</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">78,975</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>4.&nbsp;&nbsp;&nbsp;&nbsp;Accounts Receivable and Net Revenue: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Accounts receivable, net consists of the following (in thousands): </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="76%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="65%"></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2017</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Gross accounts receivable</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,790,034</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,719,642</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Allowance for contractual adjustments and uncollectibles</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1,286,035</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1,224,366</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">503,999</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">495,276</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Net revenue consists of the following (in thousands): </P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="59%"></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2017</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2015</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Gross revenue</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">11,427,238</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">10,374,813</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">8,942,957</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Contractual adjustments and uncollectibles</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(8,285,317</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(7,464,030</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(6,389,195</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Hospital contract administrative fees</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">316,391</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">272,376</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">226,234</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3,458,312</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3,183,159</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,779,996</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Accounts receivable of $504.0&nbsp;million and $495.3&nbsp;million at December&nbsp;31, 2017 and 2016,
respectively, consist primarily of amounts due from government-sponsored healthcare programs and third-party insurance payors for services provided by the Company&#146;s affiliated physicians. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Net revenue of $3.5&nbsp;billion, $3.2&nbsp;billion and $2.8&nbsp;billion for the years ended December&nbsp;31, 2017, 2016 and 2015,
respectively, consists primarily of gross billed charges for services provided by the Company&#146;s affiliated physicians less an estimated allowance for contractual adjustments and uncollectibles to properly account for the anticipated differences
between gross billed charge amounts and expected reimbursement amounts. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company&#146;s contractual adjustments and uncollectibles as
a percentage of gross patient service revenue vary slightly each year depending on several factors, including improved managed care contracting, changes in </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">78 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
reimbursement from state Medicaid programs and other government-sponsored programs, shifts in the percentage of patient services being reimbursed under government-sponsored programs and annual
price increases. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company&#146;s annual price increases typically increase contractual adjustments as a percentage of
gross patient service revenue. This increase is primarily due to Medicaid, Medicare and other government-sponsored healthcare programs that generally provide for reimbursements on a <FONT STYLE="white-space:nowrap">fee-schedule</FONT> basis rather
than on a gross charge basis. When the Company bills these programs, like other payors, on a gross-charge basis, it also increases its provision for contractual adjustments and uncollectibles by the amount of any price increase, resulting in a
higher contractual adjustment percentage. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>5.&nbsp;&nbsp;&nbsp;&nbsp;Property and Equipment: </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Property and equipment consists of the following (in thousands): </FONT></P>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="76%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="69%"></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>December&nbsp;31,</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2017</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2016</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Building</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">33,024</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">26,572</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Land</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">6,683</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">6,683</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Equipment and other</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">253,453</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">213,521</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">293,160</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">246,776</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Accumulated depreciation</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(169,624</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(143,708</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">123,536</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">103,068</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">At December&nbsp;31, 2017 and 2016, property and equipment includes medical and other equipment held
under capital leases of $6.1&nbsp;million and $6.2&nbsp;million, and related accumulated depreciation of $4.6&nbsp;million and $4.0&nbsp;million, respectively. The Company recorded depreciation expense of $33.9&nbsp;million, $29.0&nbsp;million and
$22.2&nbsp;million for the years ended December&nbsp;31, 2017, 2016 and 2015, respectively. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>6.&nbsp;&nbsp;&nbsp;&nbsp;Business
Acquisitions: </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">During the year ended December&nbsp;31, 2017, the Company completed 10 physician group practice
acquisitions, including four radiology practices, two maternal-fetal medicine practices, one neonatology practice, one pediatric multi-specialty practice and two other pediatric subspecialty practices. The acquisition-date fair value of the total
consideration for the 10 acquisitions was $554.0&nbsp;million, net of cash acquired. Approximately $531.7&nbsp;million was paid in cash, $2.7&nbsp;million was paid by issuing 69,014 shares of the Company&#146;s common stock, $18.6&nbsp;million was
recorded as a contingent consideration liability and $1.0&nbsp;million was recorded as accrued purchase consideration within other current liabilities. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">These acquisitions expanded the Company&#146;s national network of physician practices. The Company expects to improve the results of physician practices through improved managed care contracting,
improved collections and identification of growth initiatives, as well as operating and cost savings based on the significant infrastructure it has developed. With respect to the Company&#146;s acquisition of radiology physician practices, the
Company believes that it brings a unique value proposition to radiology physician groups, in that the Company can provide not only practice support, but also teleradiology capabilities that can enhance a physician group&#146;s efficiency, provide
subspecialty access and help them grow, remain competitive and meet the ever increasing demands of their hospital partners, payors and regulatory bodies. In addition, the Company believes that radiology physician group practice physicians can
complement the staffing needs for its teleradiology services business during certain times, such as nights and weekends, when such physicians are not providing services at their practices. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">79 </FONT></P>



<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The 69,014 shares of the Company&#146;s common stock issued as a component of the purchase
consideration for acquisitions completed during the first quarter and fourth quarter of 2017 had an acquisition-date fair value of $2.7&nbsp;million. The fair value of such shares was determined using the closing price on the New York Stock Exchange
of the Company&#146;s common stock less a discount for lack of marketability on the respective dates of acquisition, reflecting a three year contractual restriction on the disposition or assignment of such common stock. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company&#146;s preliminary allocation of purchase price is as follows (in thousands): </FONT></P>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="68%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="83%"></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Current assets</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">43,550</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Property and equipment</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">5,281</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Other noncurrent assets</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">52,611</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Goodwill</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">439,822</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Other intangible assets</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">39,414</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Current liabilities</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(5,674</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Other long-term liabilities</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(21,086</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">553,918</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company has recorded provisional amounts for deferred income taxes related to certain acquisitions
completed during the year ended December&nbsp;31, 2017. Any adjustments will be recorded during the measurement period and are not expected to be material. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Current assets acquired and other noncurrent assets acquired include assets with a fair value of $23.5&nbsp;million and $22.5&nbsp;million, respectively, that are expected to be sold and contributed to a
joint venture for an equity method investment in that joint venture, respectively, within the next twelve months. Accordingly, these assets are classified as held for sale. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The contingent consideration of $18.6&nbsp;million recorded during the year ended December&nbsp;31, 2017 is related to an agreement to pay an additional cash amount based on the achievement of certain
performance measures for the period through June&nbsp;1, 2019. The accrued contingent consideration was recorded as a liability at acquisition-date fair value using the income approach with assumed discount rates ranging from 4.0% to 4.75% over the
applicable terms and an assumed payment probability assessment over the applicable years. The range of the undiscounted amount the Company could pay under the contingent consideration agreement is between $0 and $20.0&nbsp;million. In connection
with this contingent consideration arrangement, the Company has designated $20.0&nbsp;million as restricted cash in its Consolidated Balance Sheet. In addition, during the year ended December&nbsp;31, 2017, the Company paid $6.2&nbsp;million for
contingent consideration related to certain prior-period acquisitions, of which all but the accretion recorded during 2017 was accrued as of December&nbsp;31, 2016. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">In connection with certain prior period acquisitions, the Company recorded an increase in deferred tax liabilities of $0.5&nbsp;million with a corresponding increase in goodwill of $0.5&nbsp;million
resulting from the finalization of income tax acquisition accounting. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">During the year ended December&nbsp;31, 2016, the
Company completed 15 acquisitions, of which 13 were physician group practices including eight anesthesiology practices, two other pediatric subspecialty practices, one neonatology practice, one maternal-fetal medicine practice and one pediatric
cardiology practice. In addition, the Company acquired a third-party receivables company and a patient engagement software company as additions to its existing management services organization. The total consideration for the 15 acquisitions was
$759.6&nbsp;million, net of $15.0&nbsp;million cash acquired, of which $756.1&nbsp;million was paid in cash and $3.5&nbsp;million was recorded as a contingent consideration liability. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">On March&nbsp;31, 2017, the Company sold its 75% economic interest in a joint venture that was previously consolidated. The
deconsolidation and removal of 100% of the carrying value of the joint venture&#146;s net assets resulted in a gain on sale that was not material. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">80 </FONT></P>



<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>7.&nbsp;&nbsp;&nbsp;&nbsp;Goodwill and Intangible Assets: </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Goodwill was $4.3&nbsp;billion and $3.8&nbsp;billion at December&nbsp;31, 2017 and 2016, respectively. The change in the carrying amount
of goodwill of $438.8&nbsp;million during the year ended December&nbsp;31, 2017 is primarily related to the Company&#146;s 2017 acquisitions. The Company expects that $159.5&nbsp;million of the goodwill recorded during the year ended
December&nbsp;31, 2017 will be deductible for tax purposes. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Intangible assets, net, consist of the following (in thousands):
</FONT></P> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="92%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="64%"></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>December&nbsp;31, 2017</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Gross<BR>Carrying<BR>Value</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Accumulated<BR>Amortization</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Net<BR>Carrying<BR>Value</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Physician and hospital agreements</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">381,635</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(203,915</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">177,720</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Customer relationships</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">443,300</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(48,837</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">394,463</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Trade names</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">43,156</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(2,933</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">40,223</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Patented and other technology</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">38,590</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(11,068</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">27,522</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">906,681</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(266,753</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">639,928</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="92%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="64%"></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>December&nbsp;31, 2016</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Gross<BR>Carrying<BR>Value</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Accumulated<BR>Amortization</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Net<BR>Carrying<BR>Value</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Physician and hospital agreements</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">347,862</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(168,488</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">179,374</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Customer relationships</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">443,300</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(27,368</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">415,932</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Trade names</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">43,156</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(1,604</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">41,552</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Patented and other technology</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">37,503</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(5,832</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">31,671</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">871,821</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(203,292</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">668,529</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">During the year ended December&nbsp;31, 2017, the Company recorded intangible assets related to
acquisitions totaling $39.4&nbsp;million, consisting primarily of physician and hospital agreements. The weighted-average amortization period for these physician and hospital agreements is approximately 10 years. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Amortization expense for intangible assets was $68.9&nbsp;million, $60.3&nbsp;million and $42.0&nbsp;million for the years ended
December&nbsp;31, 2017, 2016 and 2015, respectively. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Amortization expense for existing intangible assets for the next five
years is expected to be as follows (in thousands): </FONT></P> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="68%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="84%"></TD>
<TD VALIGN="bottom" WIDTH="8%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2018</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">67,514</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2019</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">62,669</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2020</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">56,636</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2021</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">51,069</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2022</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">44,357</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
</TABLE>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">81 </FONT></P>



<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>8.&nbsp;&nbsp;&nbsp;&nbsp;Accounts Payable and Accrued Expenses: </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Accounts payable and accrued expenses consist of the following (in thousands): </FONT></P>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="76%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="70%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>December&nbsp;31,</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2017</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2016</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Accounts payable</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">34,632</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">28,474</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Accrued salaries and bonuses</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">225,429</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">220,635</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Accrued payroll taxes and benefits</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">75,672</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">67,830</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Accrued professional liabilities</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">37,912</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">28,972</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Accrued contingent consideration</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">6,259</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">6,566</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Accrued interest</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">4,495</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">4,511</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Other accrued expenses</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">53,618</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">50,950</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">438,017</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">407,938</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>9.&nbsp;&nbsp;&nbsp;&nbsp;Accrued Professional Liabilities: </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">At December&nbsp;31, 2017 and 2016, the Company&#146;s total accrued professional liabilities of $250.2&nbsp;million and
$202.1&nbsp;million, respectively, includes incurred but not reported loss reserves of $138.5&nbsp;million and $128.1&nbsp;million, respectively, and loss reserves for reported claims of $111.7&nbsp;million and $74.0&nbsp;million, respectively. Of
the total liability, $37.9&nbsp;million is classified as a current liability within accounts payable and accrued expenses in the Consolidated Balance Sheet. In addition, there is a corresponding insurance receivable of $18.9&nbsp;million recorded as
a component of other assets for certain professional liability claims that are covered by third-party insurance policies. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The
activity related to the Company&#146;s total accrued professional liability for the years ended December&nbsp;31, 2017, 2016 and 2015 is as follows (in thousands): </FONT></P> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="63%"></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Years Ended December&nbsp;31,</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2017</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2016</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2015</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Balance at beginning of year</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">202,052</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">202,527</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">168,369</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Assumed liabilities through acquisition</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">20,716</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#151;&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">35,968</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Provision (adjustment) for losses related to:</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Current year</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">41,291</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">38,129</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">39,204</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Prior years</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">9,983</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(25,428</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(25,797</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Total provision for losses</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">51,274</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">12,701</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">13,407</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Claim payments related to:</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Current year</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(712</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(766</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(1,382</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Prior years</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(23,143</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(12,410</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(13,835</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Total payments</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(23,855</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(13,176</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(15,217</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Balance at end of year</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">250,187</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">202,052</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">202,527</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The net increase in the Company&#146;s total accrued professional liability for the year ended
December&nbsp;31, 2017 is primarily related to growth in the program from acquisitions as well as overall unfavorable trends in the Company&#146;s claims experience. The net decrease in 2016 was primarily attributable to the overall favorable trends
in the Company&#146;s claims experience. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>10.&nbsp;&nbsp;&nbsp;&nbsp;Line of Credit, Long-Term Debt and Capital Lease Obligations:
</B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">On October&nbsp;30, 2017, the Company entered into a new credit agreement (the &#147;New Credit Agreement&#148;), which
replaces the Company&#146;s prior credit agreement. The New Credit Agreement provides for a $2.0&nbsp;billion </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">82 </FONT></P>



<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
unsecured revolving credit facility and includes a $37.5&nbsp;million <FONT STYLE="white-space:nowrap">sub-facility</FONT> for the issuance of letters of credit. The New Credit Agreement matures
on October&nbsp;31, 2022 and is guaranteed by substantially all of the Company&#146;s subsidiaries and affiliated professional associations and corporations. At the Company&#146;s option, borrowings under the New Credit Agreement will bear interest
at (i)&nbsp;the alternate base rate (defined as the higher of (a)&nbsp;the prime rate, (b)&nbsp;the Federal Funds Rate plus 1/2 of 1.00% and (c)&nbsp;LIBOR for an interest period of one month plus 1.00%) plus an applicable margin rate ranging from
0.125% to 0.750% based on the Company&#146;s consolidated leverage ratio or (ii)&nbsp;the LIBOR rate plus an applicable margin rate ranging from 1.125% to 1.750% based on the Company&#146;s consolidated leverage ratio. The New Credit Agreement also
calls for other customary fees and charges, including an unused commitment fee ranging from 0.150% to 0.300% of the unused lending commitments, based on the Company&#146;s consolidated leverage ratio. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The New Credit Agreement contains customary covenants and restrictions, including covenants that require the Company to maintain a
minimum interest charge ratio, not to exceed a specified consolidated leverage ratio and to comply with laws, and restrictions on the ability of the Company to pay dividends and make certain other distributions, as specified therein. Failure to
comply with these covenants would constitute an event of default under the New Credit Agreement, notwithstanding the ability of the Company to meet its debt service obligations. The New Credit Agreement also includes various customary remedies for
the lenders following an event of default, including the acceleration of repayment of outstanding amounts under the New Credit Agreement. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">On December&nbsp;8, 2015, the Company completed a private offering of $750.0&nbsp;million aggregate principal amount of 2023 Senior Notes. The Company&#146;s obligations under the 2023 Senior Notes are
guaranteed on an unsecured senior basis by the same subsidiaries and affiliated professional contractors that guarantee the Credit Agreement. Interest on the 2023 Senior Notes accrues at the rate of 5.25% per annum and is payable semi-annually in
arrears on June&nbsp;1 and December 1. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">At any time prior to December&nbsp;1, 2018, the Company may redeem all or a portion of
the 2023 Senior Notes at a redemption price equal to 100% of the principal amount of the notes being redeemed plus an applicable redemption premium and accrued and unpaid interest to the redemption date. In addition, at any time prior to
December&nbsp;1, 2018, the Company may redeem up to 35% of the aggregate principal amount of the 2023 Senior Notes at a redemption price of 105.250% of the principal amount thereof, plus accrued and unpaid interest, if any, to the redemption date,
using proceeds from one or more equity offerings. On or after December&nbsp;1, 2018, the Company may redeem all or a portion of the 2023 Senior Notes, at the redemption prices of 103.938% in 2018, 102.625% in 2019, 101.313% in 2020 and 100% in 2021
and thereafter, plus accrued and unpaid interest to the redemption date. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The indenture under which the 2023 Senior Notes are
issued, among other things, limits our ability to (1)&nbsp;incur liens and (2)&nbsp;enter into sale and lease-back transactions, and also limits our ability to merge or dispose of all or substantially all of our assets, in all cases, subject to a
number of customary exceptions. Although we are not required to make mandatory redemption or sinking fund payments with respect to the 2023 Senior Notes, upon the occurrence of a change in control of MEDNAX, we may be required to repurchase the 2023
Senior Notes at a purchase price equal to 101% of the aggregate principal amount of the 2023 Senior Notes repurchased plus accrued and unpaid interest. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The Company presents issuance costs related to long-term debt liabilities, other than revolving credit arrangements, as a direct deduction from the carrying value of that long-term debt. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">83 </FONT></P>



<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The carrying value of the Company&#146;s long-term debt was $1.8&nbsp;billion and
$1.7&nbsp;billion at December&nbsp;31, 2017 and 2016, respectively, and consisted of the following (in thousands): </FONT></P> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="56%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>December&nbsp;31, 2017</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Principal</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Unamortized<BR>Debt<BR>Issuance<BR>Costs</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Total</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2023 Senior Notes</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">750,000</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(9,503</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">740,497</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Revolving line of credit</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,110,500</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(4,864</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,105,636</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Total</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,860,500</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(14,367</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,846,133</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="57%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>December&nbsp;31, 2016</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Principal</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Unamortized<BR>Debt<BR>Issuance<BR>Costs</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Total</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2023 Senior Notes</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">750,000</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(11,109</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">738,891</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Revolving line of credit</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">783,500</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(3,388</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">780,112</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Term loan</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">180,000</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(259</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">179,741</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,713,500</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(14,756</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,698,744</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Less: Current portion</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(20,000</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#151;&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(20,000</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Long-term portion</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,693,500</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(14,756</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,678,744</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company has outstanding letters of credit which reduced the amount available under the New Credit
Agreement by $0.2&nbsp;million at December&nbsp;31, 2017. At December&nbsp;31, 2017, the Company had an available balance on its New Credit Agreement of $889.3&nbsp;million. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The carrying values of the Company&#146;s variable rate revolving line of credit approximates fair value due to the short-term nature of the interest rates. The estimated fair value of the Company&#146;s
2023 Notes was $763.1&nbsp;million and $773.4&nbsp;million, at December&nbsp;31, 2017 and 2016, respectively, and was estimated using trading prices as of December&nbsp;31, 2017 and December&nbsp;31, 2016 as Level&nbsp;2 inputs to estimate fair
value. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company&#146;s capital lease obligations consist of the following (in thousands): </FONT></P>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="76%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="75%"></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>December&nbsp;31,</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2017</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2016</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Capital lease obligations</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,826</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3,550</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Less: Current portion</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(1,401</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(2,054</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Long-term portion</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">425</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,496</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The amounts due under the terms of the Company&#146;s capital lease obligations at December&nbsp;31, 2017
are as follows: </FONT></P> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="68%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="86%"></TD>
<TD VALIGN="bottom" WIDTH="8%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2018</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,401</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2019</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">238</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2020</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">113</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">2021</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">74</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
</TABLE>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">84 </FONT></P>



<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>11.&nbsp;&nbsp;&nbsp;&nbsp;Income Taxes: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The components of the income tax provision (benefit) are as follows (in thousands): </P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="62%"></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2017</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2015</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Federal:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Current</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">130,053</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">166,758</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">168,596</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Deferred</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(63,038</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">15,596</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">12,866</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">67,015</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">182,354</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">181,462</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">State:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Current</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">20,070</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,296</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">20,948</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Deferred</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,965</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,553</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,628</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">23,035</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6,849</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">22,576</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">90,050</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">189,203</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">204,038</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company files its tax return on a consolidated basis with its subsidiaries. The remaining affiliated
professional contractors file tax returns on an individual basis. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The effective tax rate was 21.94%, 36.80% and 37.76% for the years
ended December&nbsp;31, 2017, 2016 and 2015, respectively. During the three months ended December&nbsp;31, 2017, the Company recorded a $70.0&nbsp;million income tax benefit related to the reduction of its net deferred tax liability resulting from
the reduction in the corporate tax rate enacted in December 2017 under the Tax Cuts and Jobs Act of 2017. Excluding this favorable impact, our effective income tax rate for the year ended December&nbsp;31, 2017 was 39.00%. During the three months
ended September&nbsp;30, 2016, the Company settled a certain tax matter with a taxing authority. In connection with this settlement, the Company&#146;s effective income tax rate was favorably impacted by $10.6&nbsp;million. Excluding this favorable
impact, the effective tax rate for December&nbsp;31, 2016 was 38.87%, as compared to 37.76% for 2015. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The differences between the
effective rate and the United States federal income tax statutory rate are as follows: </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="75%"></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2017</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2015</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Tax at statutory rate</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">35.00</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">35.00</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">35.00</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">State income tax, net of federal benefit</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3.33</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2.94</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2.97</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><FONT STYLE="white-space:nowrap">Non-deductible</FONT> expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.49</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.43</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.34</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Change in accrual estimates relating to uncertain tax positions</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.02</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2.11</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(0.43</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Change in valuation allowance</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.48</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.29</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Other, net</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.16</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.06</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(0.41</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Change in tax law</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(17.06</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income tax provision</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">21.94</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">36.80</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">37.76</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">85 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">All of the Company&#146;s deferred tax assets and liabilities are classified as long-term.
The significant components of deferred income tax assets and liabilities are as follows (in thousands): </FONT></P> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="76%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="69%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>December&nbsp;31,</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2017</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2016</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Allowance for uncollectible accounts</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">80,056</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">103,525</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Reserves and accruals</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">45,454</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">62,212</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Stock-based compensation</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">7,975</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">13,726</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Net operating loss carryforward</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">28,569</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">49,156</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Property and equipment</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">685</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,621</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Other</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">970</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,610</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Deferred tax assets before valuation allowance</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">163,709</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">231,850</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Less: Valuation allowance</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(2,615</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(4,014</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Deferred tax assets, net of valuation allowance</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">161,094</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">227,836</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Gross deferred tax liabilities:</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Amortization</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(258,618</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(380,594</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Accrual to cash adjustment</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(31,290</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(53,771</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Other</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(4,150</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(1,023</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:5.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Total deferred tax liabilities</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(294,058</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(435,388</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:5.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Net deferred tax liability</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(132,964</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(207,552</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company&#146;s net deferred tax liability decreased by $74.6&nbsp;million during 2017 of which
$70.0&nbsp;million is related to a reduction in the corporate tax rate enacted under the Tax Cuts and Jobs Act of 2017. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Beginning January&nbsp;1, 2017, excess tax benefits or deficiencies associated with the exercise of stock options, the vesting of
restricted and deferred stock and the purchase of shares under the Company&#146;s <FONT STYLE="white-space:nowrap">non-qualified</FONT> employee stock purchase plan are recognized as income tax benefits or expenses in the income statement in the
reporting period in which they occur instead of an increase or decrease to additional <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">paid-in-capital.</FONT></FONT> For the year ended December&nbsp;31, 2017, income tax expense of
$0.2&nbsp;million was recognized for excess tax deficiencies. For the years ended December&nbsp;31, 2016 and 2015, respectively, additional <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">paid-in-capital</FONT></FONT> was increased
by $4.2&nbsp;million and $11.6&nbsp;million for excess tax benefits. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company has net operating loss carryforwards for
federal and state tax purposes totaling $116.0&nbsp;million, $130.0&nbsp;million, and $136.6&nbsp;million at December&nbsp;31, 2017, 2016 and 2015, respectively, expiring at various times in 2019 through 2037. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">As of December&nbsp;31, 2017, 2016 and 2015, the Company&#146;s liability for uncertain tax positions, excluding accrued interest and
penalties, was $11.0&nbsp;million, $9.5&nbsp;million and $18.4&nbsp;million, respectively. As of December&nbsp;31, 2017, the Company had $10.7&nbsp;million of uncertain tax positions that, if recognized, would favorably impact its effective tax
rate. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">86 </FONT></P>



<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The following table summarizes the activity related to the Company&#146;s liability for
uncertain tax positions for the years ended December&nbsp;31, 2017, 2016 and 2015 (in thousands): </FONT></P> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="66%"></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Years Ended December&nbsp;31,</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2017</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2016</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2015</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Balance at beginning of year</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">9,469</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">18,447</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">17,165</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Increases related to prior year tax positions</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,284</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">301</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">467</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Decreases related to prior year tax positions</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(143</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(3,927</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(1,168</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Increases related to current year tax positions</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,430</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2,258</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">3,675</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Settlements</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#151;&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(5,644</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#151;&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Decreases related to lapse of statutes of limitation</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(2,068</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(1,966</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(1,692</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Balance at end of year</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">10,972</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">9,469</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">18,447</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">During the year ended December&nbsp;31, 2017, the Company increased its liability for uncertain tax
positions by a total of $1.5&nbsp;million, primarily related to additional taxes on current and prior year positions, partially offset by the expiration of statutes of limitation. During the year ended December&nbsp;31, 2016, the Company decreased
its liability for uncertain tax positions by a total of $9.0&nbsp;million, primarily related to the settlement of a certain tax matter with a taxing authority and the expiration of statutes of limitation, partially offset by additional taxes on
current year positions. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In addition, the Company anticipates that its liability for uncertain tax positions will be decreased
by $1.1&nbsp;million related to the expiration of certain statutes of limitation over the next 12 months. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company
includes interest and penalties related to income tax liabilities in income tax expense. The Company recognized an income tax benefit of $0.2&nbsp;million and $7.9&nbsp;million and income tax expense of $0.6&nbsp;million related to interest and
penalties during the years ended December&nbsp;31, 2017, 2016 and 2015, respectively. At December&nbsp;31, 2017 and 2016, the Company&#146;s accrued liability for interest and penalties related to income tax liabilities totaled $1.2&nbsp;million and
$1.4&nbsp;million, respectively. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company is currently subject to U.S. Federal and various state income tax examinations
for the tax years 2013 through 2016. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>12.&nbsp;&nbsp;&nbsp;&nbsp;Common and Common Equivalent Shares: </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The calculation of shares used in the basic and diluted net income per share calculation for the years ended December&nbsp;31, 2017, 2016
and 2015 is as follows (in thousands): </FONT></P> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="92%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="73%"></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Years Ended December&nbsp;31,</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2017</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2016</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>2015</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Weighted average number of common shares outstanding</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">92,431</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">92,422</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">93,077</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Weighted average number of dilutive common share equivalents</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">527</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">687</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">883</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Weighted average number of common and common equivalent shares outstanding</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">92,958</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">93,109</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">93,960</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Antidilutive securities not included in the diluted net income per common share calculation</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">107</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">2</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">&#151;&nbsp;&nbsp;</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>13.&nbsp;&nbsp;&nbsp;&nbsp;Stock Incentive Plans and Stock Purchase Plans: </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company&#146;s Amended and Restated 2008 Incentive Compensation Plan, as amended (the &#147;Amended and Restated 2008 Incentive
Plan&#148;) provides for grants of stock options, stock appreciation rights, restricted stock, deferred stock, and other stock-related awards and performance awards that may be settled in cash, stock or other property. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">87 </FONT></P>



<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Under the Amended and Restated 2008 Incentive Plan, options to purchase shares of common
stock may be granted at a price not less than the fair market value of the shares on the date of grant. The options must be exercised within 10 years from the date of grant and generally become exercisable on a pro rata basis over a three-year
period from the date of grant. The Company issues new shares of its common stock upon exercise of its stock options. Restricted stock awards generally vest over periods of three years upon the fulfillment of specified service-based conditions and in
certain instances performance-based conditions. Deferred stock awards generally vest upon the satisfaction of specified performance-based conditions or service-based conditions. The Company recognizes compensation expense related to its restricted
stock and deferred stock awards ratably over the corresponding vesting periods. At December&nbsp;31, 2017, the Company had 3.4&nbsp;million shares available for future grants and awards under its Amended and Restated 2008 Incentive Plan. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Under the Company&#146;s 1996 <FONT STYLE="white-space:nowrap">Non-Qualified</FONT> Employee Stock Purchase Plan, as amended (the
&#147;ESPP&#148;), employees are permitted to purchase the Company&#146;s common stock at 85% of market value on January 1st, April 1st, July 1st and October 1st of each year. Under the Company&#146;s 2015
<FONT STYLE="white-space:nowrap">Non-Qualified</FONT> Stock Purchase Plan (the &#147;SPP&#148;), certain eligible non-employee service providers are permitted to purchase the Company&#146;s common stock at 90% of market value on January 1st, April
1st, July 1st and October 1st of each year upon the SPP&#146;s effective date of January&nbsp;1, 2016. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Each of the ESPP and
the SPP provide for the issuance of an of aggregate 2.6&nbsp;million shares of the Company&#146;s common stock less the number of shares of common stock purchased under the other plan. The Company recognizes stock-based compensation expense for the
discount received by participating employees and <FONT STYLE="white-space:nowrap">non-employee</FONT> service providers. During the year ended December&nbsp;31, 2017, 0.4&nbsp;million shares were issued under the ESPP and SPP. At December&nbsp;31,
2017, the Company had 1.9&nbsp;million shares in aggregate reserved for issuance under the ESPP and SPP. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company
recognized $29.6&nbsp;million, $34.0&nbsp;million and $32.1&nbsp;million of stock-based compensation expense related to its stock incentive plans, the ESPP and the SPP during the years ended December&nbsp;31, 2017, 2016 and 2015, respectively.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The activity related to the Company&#146;s restricted stock and deferred stock awards and the corresponding weighted average
grant-date fair values for the year ended December&nbsp;31, 2017 are as follows: </FONT></P> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="76%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="68%"></TD>
<TD VALIGN="bottom" WIDTH="8%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Number of</B></FONT><br><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Shares</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Weighted<BR>Average&nbsp;Fair<BR>Value</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2"><FONT STYLE="white-space:nowrap">Non-vested</FONT> shares at January&nbsp;1, 2017</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">946,329</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">66.98</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Awarded</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">637,529</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">54.22</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Forfeited</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(91,730</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">64.82</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Vested</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(451,094</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">65.00</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2"><FONT STYLE="white-space:nowrap">Non-vested</FONT> shares at December&nbsp;31, 2017</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1,041,034</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">60.21</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
</TABLE> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The aggregate fair value of the restricted and deferred stock that vested during the years ended
December&nbsp;31, 2017, 2016 and 2015 was $29.3&nbsp;million, $29.8&nbsp;million and $31.6&nbsp;million, respectively. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The
weighted average grant-date fair value of restricted and deferred stock awards that were granted during the years ended December&nbsp;31, 2017, 2016 and 2015 was $54.22, $67.90 and $70.44, respectively. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">At December&nbsp;31, 2017, the total stock-based compensation cost related to <FONT STYLE="white-space:nowrap">non-vested</FONT>
restricted and deferred stock remaining to be recognized as compensation expense over a weighted-average period of 1.6 years was $30.9&nbsp;million. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">88 </FONT></P>



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<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The Company did not grant any stock options in 2017, 2016 or 2015, and all stock-based
compensation cost related to stock options has been recognized. The activity and certain other information related to the Company&#146;s outstanding stock option awards for the year ended December&nbsp;31, 2017 are as follows: </FONT></P>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="92%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="51%"></TD>
<TD VALIGN="bottom" WIDTH="8%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="8%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="8%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Number&nbsp;of</B></FONT><br><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Stock&nbsp;
Options</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Weighted</B></FONT><br><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Average</B></FONT><br><FONT
STYLE="font-family:Times New Roman" SIZE="1"><B>Exercise</B></FONT><br><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Price</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Weighted<BR>Average<BR>Remaining<BR>Contractual<BR>Term</B></FONT><br><FONT
STYLE="font-family:Times New Roman" SIZE="1"><B>(in years)</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Aggregate<BR>Intrinsic</B></FONT><br><FONT STYLE="font-family:Times New Roman" SIZE="1"><B>Value</B></FONT><br>
<FONT STYLE="font-family:Times New Roman" SIZE="1"><B>(in&nbsp;millions)</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Outstanding at January&nbsp;1, 2017</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">410,286</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">28.33</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:3.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Exercised</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">(163,944</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">29.57</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.5</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:1px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Outstanding and exercisable at December&nbsp;31, 2017</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">246,342</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">27.51</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">1.5</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">$</FONT></TD>
<TD VALIGN="bottom" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2">6.4</FONT></TD>
<TD NOWRAP VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;</FONT></TD></TR>
<TR STYLE="font-size:1px">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE="border-top:3px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">The aggregate intrinsic value of stock options exercised during the years ended December&nbsp;31, 2017,
2016 and 2015 was $5.5&nbsp;million, $6.8&nbsp;million and $11.3&nbsp;million, respectively. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">There were no excess tax
benefits recognized in additional <FONT STYLE="white-space:nowrap">paid-in</FONT> capital due to the adoption of new accounting guidance on January&nbsp;1, 2017 that requires excess tax benefits to be recognized in the income statement. The net
excess tax benefit recognized in additional <FONT STYLE="white-space:nowrap">paid-in</FONT> capital related primarily to stock options, restricted stock and deferred stock for the years ended December&nbsp;31, 2016 and 2015 was $4.1&nbsp;million and
$11.6&nbsp;million, respectively. The cash proceeds received from the exercise of stock options for the years ended December&nbsp;31, 2017, 2016 and 2015 were $4.8&nbsp;million, $4.7&nbsp;million and $6.1&nbsp;million, respectively. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>14.&nbsp;&nbsp;&nbsp;&nbsp;Common Stock Repurchase Programs: </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">In July 2013, the Company&#146;s Board of Directors authorized the repurchase of shares of the Company&#146;s common stock up to an amount sufficient to offset the dilutive impact from the issuance of
shares under the Company&#146;s equity compensation programs. The share repurchase program allows the Company to make open market purchases from <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">time-to-time</FONT></FONT> based on
general economic and market conditions and trading restrictions. The repurchase program also allows for the repurchase of shares of the Company&#146;s common stock to offset the dilutive impact from the issuance of shares, if any, related to the
Company&#146;s acquisition program. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">During the year ended December&nbsp;31, 2017, the Company repurchased 1.0&nbsp;million
shares of its common stock for $70.2&nbsp;million, inclusive of 38,257 shares withheld to satisfy minimum statutory withholding obligations of $2.1&nbsp;million in connection with the vesting of restricted stock. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In October 2014, the Company&#146;s Board of Directors authorized the repurchase of up to $600.0&nbsp;million of shares of the
Company&#146;s common stock in addition to its existing share repurchase program. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In December 2014, the Company entered into
an uncollared accelerated share repurchase (&#147;ASR&#148;) agreement with an investment bank. Under the ASR agreement, the Company agreed to purchase $200.0&nbsp;million of its common stock in total. On December&nbsp;17, 2014, the Company paid a
total of $200.0&nbsp;million to an investment bank, which in turn delivered to the Company 2.5&nbsp;million shares of the Company&#146;s common stock in total based on the market price of a share of Company common stock on December&nbsp;12, 2014.
The payment was recorded as a reduction to the respective components of shareholders&#146; equity. The final number of shares of common stock that the Company may receive, or may be required to remit, upon settlement under the ASR agreement was to
be based upon the average daily volume weighted-average price of the Company&#146;s common stock during the term of the ASR agreement, less a negotiated discount. The ASR agreement was funded by borrowings under the Company&#146;s Credit Agreement
discussed in Note 10. Final settlement of the ASR occurred in July 2015 with the delivery to the Company of 0.3&nbsp;million additional shares of common stock. The final number of shares of common stock that the Company received was based upon the
average daily volume </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">89 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
weighted-average price of the Company&#146;s common stock during the term of the ASR agreement, less a negotiated discount. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In March 2015, the Company entered into a second uncollared ASR agreement with an investment bank. Under the ASR agreement, the Company
agreed to purchase $200.0&nbsp;million of its common stock in total. On March&nbsp;16, 2015, the Company paid a total of $200.0&nbsp;million to an investment bank, which in turn delivered to the Company 2.2&nbsp;million shares of the Company&#146;s
common stock in total based on the market price of a share of Company common stock on March&nbsp;12, 2015. The ASR agreement was funded by borrowings under the Company&#146;s Credit Agreement, and the payment was recorded as a reduction to the
respective components of shareholders&#146; equity. Final settlement of the ASR occurred in October 2015 with the delivery to the Company of 0.3&nbsp;million additional shares of common stock. The final number of shares of common stock that the
Company received was based upon the average daily volume weighted-average price of the Company&#146;s common stock during the term of the ASR agreement, less a negotiated discount. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">During the year ended December&nbsp;31, 2016, the Company repurchased 0.9&nbsp;million shares of its common stock for $61.8&nbsp;million,
inclusive of 46,490 shares withheld to satisfy minimum stock withholding obligations of $3.2&nbsp;million in connection with the vesting of restricted stock. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The Company intends to utilize various methods to effect any future share repurchases, including, among others, open market purchases and accelerated share repurchase programs. The amount and timing of
repurchases will depend upon several factors, including general economic and market conditions and trading restrictions. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>15.&nbsp;&nbsp;&nbsp;&nbsp;Retirement Plans: </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The Company maintains six qualified contributory savings plans as allowed under Section&nbsp;401(k) of the Internal Revenue Code and Section&nbsp;1165(e) of the Puerto Rico Income Tax Act of 1954 (the
&#147;401(k) Plans&#148;). The 401(k) Plans permit participant contributions and allow elective and, in certain situations, <FONT STYLE="white-space:nowrap">non-elective</FONT> Company contributions based on each participant&#146;s contribution or a
specified percentage of eligible wages. Participants may defer a percentage of their annual compensation subject to the limits defined in the 401(k) Plans. The Company recorded expense of $50.7&nbsp;million, $45.2&nbsp;million and $39.7&nbsp;million
for the years ended December&nbsp;31, 2017, 2016 and 2015, respectively, primarily related to the 401(k) Plans. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>16.&nbsp;&nbsp;&nbsp;&nbsp;Commitments and Contingencies: </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The Company expects that audits, inquiries and investigations from government authorities and agencies will occur in the ordinary course of business. Such audits, inquiries and investigations and their
ultimate resolutions, individually or in the aggregate, could have a material adverse effect on the Company&#146;s business, financial condition, results of operations, cash flows and the trading price of its common stock. The Company has not
included an accrual for these matters as of December&nbsp;31, 2017 in its Consolidated Financial Statements, as the variables affecting any potential eventual liability depend on the currently unknown facts and circumstances that arise out of, and
are specific to, any particular future audit, inquiry and investigation and cannot be reasonably estimated at this time. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In
the ordinary course of business, the Company becomes involved in pending and threatened legal actions and proceedings, most of which involve claims of medical malpractice related to medical services provided by the Company&#146;s affiliated
physicians. The Company&#146;s contracts with hospitals generally require the Company to indemnify them and their affiliates for losses resulting from the negligence of the Company&#146;s affiliated physicians. The Company may also become subject to
other lawsuits which could involve large claims and significant costs. The Company believes, based upon a review of pending actions and proceedings, that the outcome of such legal actions and proceedings will not have a material adverse effect on
its business, financial condition, results of operations, cash flows and the trading price of its securities. The outcome of such actions and proceedings, however, cannot be predicted with certainty and an unfavorable resolution of one or more of
</FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">90 </FONT></P>



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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
them could have a material adverse effect on the Company&#146;s business, financial condition, results of operations, cash flows and the trading price of its securities. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Although the Company currently maintains liability insurance coverage intended to cover professional liability and certain other claims, the
Company cannot assure that its insurance coverage will be adequate to cover liabilities arising out of claims asserted against it in the future where the outcomes of such claims are unfavorable. With respect to professional liability risk, the
Company generally self-insures a portion of this risk through its wholly owned captive insurance subsidiary. Liabilities in excess of the Company&#146;s insurance coverage, including coverage for professional liability and certain other claims,
could have a material adverse effect on the Company&#146;s business, financial condition, results of operations, cash flows and the trading price of its securities. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company leases space for its regional, medical and business offices, storage space and temporary housing of medical staff. The Company
also leases an aircraft. Rent expense for the years ended December&nbsp;31, 2017, 2016 and 2015 was $42.6&nbsp;million, $38.0&nbsp;million and $31.6&nbsp;million, respectively. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Future minimum lease payments under <FONT STYLE="white-space:nowrap">non-cancelable</FONT> operating leases as of December&nbsp;31, 2017 are
as follows (in thousands):<B></B><B>&nbsp;</B> </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="68%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="83%"></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">2018</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">34,337</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">2019</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">24,178</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">2020</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">16,633</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">2021</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">12,065</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">2022</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">8,125</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Thereafter</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">9,934</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">105,272</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">91 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>17.&nbsp;&nbsp;&nbsp;&nbsp;Selected Quarterly Financial Information (Unaudited): </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following tables set forth a summary of the Company&#146;s selected quarterly financial information for each of the four quarters ended
December&nbsp;31, 2017 and 2016 (in thousands, except for per share data): </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="64%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="14" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2017 Quarters</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>First</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Second</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Third</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Fourth</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net revenue</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">835,597</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">842,944</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">868,951</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">910,820</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Operating expenses:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Practice salaries and benefits</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">572,385</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">561,418</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">586,476</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">617,455</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Practice supplies and other operating expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">27,796</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">30,872</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">29,497</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">32,353</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">General and administrative expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">103,765</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">103,015</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">101,430</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">108,895</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Depreciation and amortization</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">25,614</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">25,735</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">25,116</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">26,414</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total operating expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">729,560</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">721,040</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">742,519</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">785,117</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income from operations</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">106,037</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">121,904</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">126,432</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">125,703</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Investment and other income</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">576</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">365</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">235</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,777</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Interest expense</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(17,752</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(18,535</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(18,428</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(19,844</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Equity (losses) in earnings of unconsolidated affiliate</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">797</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">689</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(240</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(294</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total <FONT STYLE="white-space:nowrap">non-operating</FONT> expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(16,379</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(17,481</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(18,433</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(17,361</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income before income taxes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">89,658</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">104,423</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">107,999</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">108,342</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income tax (provision) benefit</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(34,967</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(40,725</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(42,119</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">27,761</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income attributable to MEDNAX, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">54,691</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">63,698</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">65,880</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">136,103</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Per common and common equivalent share data (1):</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income attributable to MEDNAX, Inc.:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Basic</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.59</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.69</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.71</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1.47</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Diluted</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.59</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.69</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.71</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1.46</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Weighted average common shares:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Basic</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,360</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,181</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,589</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,756</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Diluted</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,143</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,812</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,881</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,159</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">(1)</TD>
<TD ALIGN="left" VALIGN="top">Basic and diluted per share amounts are computed for each of the periods presented. Accordingly, the sum of the quarterly per share amounts may not agree with the full year amount. </TD></TR></TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">92 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>



<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="64%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="14" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2016 Quarters</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>First</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Second</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Third</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Fourth</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net revenue</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">752,624</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">771,759</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">828,006</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">830,770</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Operating expenses:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Practice salaries and benefits</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">491,811</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">484,625</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">521,832</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">532,952</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Practice supplies and other operating expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">27,046</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">26,992</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">31,641</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">32,737</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">General and administrative expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">89,950</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,116</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,457</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">97,049</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Depreciation and amortization</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">19,584</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">20,241</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">24,185</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">25,254</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total operating expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">628,391</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">623,974</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">671,115</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">687,992</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income from operations</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">124,233</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">147,785</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">156,891</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">142,778</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Investment and other income</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">618</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">410</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">221</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">770</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Interest expense</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(14,463</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(15,058</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(17,215</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(16,356</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Equity in earnings of unconsolidated affiliate</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">794</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">789</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">796</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">806</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total <FONT STYLE="white-space:nowrap">non-operating</FONT> expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(13,051</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(13,859</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(16,198</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(14,780</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income before income taxes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">111,182</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">133,926</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">140,693</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">127,998</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income tax provision</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(43,411</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(51,601</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(44,272</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(49,919</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">67,771</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">82,325</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">96,421</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">78,079</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net loss attributable to noncontrolling interests</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">128</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">102</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">88</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income attributable to MEDNAX, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">67,899</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">82,427</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">96,509</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">78,079</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Per common and common equivalent share data (2):</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income attributable to MEDNAX, Inc.:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Basic</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.74</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.89</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1.04</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.84</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Diluted</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.73</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.89</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1.04</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.84</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Weighted average common shares:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Basic</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,269</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,182</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,604</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,728</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Diluted</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,091</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,945</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,146</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,347</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">(2)</TD>
<TD ALIGN="left" VALIGN="top">Basic and diluted per share amounts are computed for each of the periods presented. Accordingly, the sum of the quarterly per share amounts may not agree with the full year amount. </TD></TR></TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">93 </P>


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<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="9%" VALIGN="top" ALIGN="left"><B><A NAME="tx463027_12"></A>ITEM&nbsp;9.</B></TD>
<TD ALIGN="left" VALIGN="top"><B>CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE </B></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">None. </P> <P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx463027_13"></A>ITEM&nbsp;9A.</B></TD>
<TD ALIGN="left" VALIGN="top"><B>CONTROLS AND PROCEDURES </B></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Evaluation of Disclosure Controls and Procedures </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We carried out an evaluation, under the supervision and with the participation of our management, including our Chief Executive Officer and
Chief Financial Officer, of the effectiveness of our disclosure controls and procedures (as defined in Rules <FONT STYLE="white-space:nowrap">13a-15(e)</FONT> and <FONT STYLE="white-space:nowrap">15d-15(e)</FONT> under the Securities Exchange Act of
1934, as amended). Based upon that evaluation, the Chief Executive Officer and Chief Financial Officer have concluded that our disclosure controls and procedures were effective as of the end of the period covered by this report. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Management&#146;s Annual Report on Internal Control Over Financial Reporting </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Management of the Company is responsible for establishing and maintaining adequate internal control over financial reporting as defined in Rule
<FONT STYLE="white-space:nowrap">13a-15(f)</FONT> or <FONT STYLE="white-space:nowrap">15d-15(f)</FONT> promulgated under the Securities Exchange Act of 1934, as amended. The Company&#146;s internal control over financial reporting includes those
policies and procedures that (i)&nbsp;pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the Company; (ii)&nbsp;provide reasonable assurance that
transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the Company are being made only in accordance with authorizations
of management and directors of the Company; and (iii)&nbsp;provide reasonable assurance regarding the prevention or timely detection of unauthorized acquisition, use, or disposition of the Company&#146;s assets that could have a material effect on
the Company&#146;s financial statements. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Internal control over financial reporting is designed to provide reasonable assurance regarding
the reliability of financial reporting and the preparation of financial statements prepared for external purposes in accordance with generally accepted accounting principles. Because of its inherent limitations, internal control over financial
reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance
with the policies or procedures may deteriorate. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Management assessed the effectiveness of the Company&#146;s internal control over
financial reporting as of the end of the period covered by this report. In making this assessment, management used the criteria set forth by the Committee of Sponsoring Organizations of the Treadway Commission (&#147;COSO&#148;) in &#147;Internal
Control&#151;Integrated Framework (2013).&#148; Based on our assessment we concluded that, as of the end of the period covered by this report, the Company&#146;s internal control over financial reporting was effective based on those criteria. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Management has excluded four radiology physician practices from its assessment of internal control over financial reporting as of
December&nbsp;31, 2017 because they were acquired by the Company in purchase business combinations during 2017. The aggregate total assets and aggregate net revenue excluded from the Company&#146;s assessment of internal control over financial
reporting represent approximately 2% and 3%, respectively, of the related consolidated financial statement amounts as of and for the year ended December&nbsp;31, 2017. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company&#146;s independent registered certified public accounting firm, PricewaterhouseCoopers LLP, has audited our internal control over
financial reporting as of December&nbsp;31, 2017 as stated in their report which appears in this Annual Report on Form <FONT STYLE="white-space:nowrap">10-K.</FONT> </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Changes in Internal Control Over Financial Reporting </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">No change in our internal control over financial reporting occurred during our last fiscal quarter that has materially affected, or is
reasonably likely to materially affect, our internal control over financial reporting. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">94 </P>


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<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx463027_13a"></A>Item&nbsp;9B.</B></TD>
<TD ALIGN="left" VALIGN="top"><B>OTHER INFORMATION. </B></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">On February 12, 2018, the Company, through a wholly-owned
subsidiary, entered into an Employment Agreement with Vivian Lopez-Blanco, the Chief Financial Officer and Treasurer of the Company (the &#147;<U>Employment Agreement</U>&#148;). The Employment Agreement replaces Ms. Lopez-Blanco&#146;s current
employment agreement with a wholly-owned subsidiary of the Company, which employment agreement will expire by its terms on May 26, 2018 and will not be renewed. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Pursuant to the Employment Agreement, Ms. Lopez-Blanco will receive an annual base salary as determined by the Compensation Committee of the
Company&#146;s Board of Directors (the &#147;<U>Compensation Committee</U>&#148;) and will be eligible to receive an annual performance bonus in accordance with Compensation Committee-approved incentive programs, with a target bonus payment of at
least 100% of her base salary. The Employment Agreement also provides for participation in customary benefit plans and the Company&#146;s incentive compensation plans, as determined by the Compensation Committee. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Upon the termination of Ms. Lopez-Blanco&#146;s employment for certain specified reasons, the Employment Agreement provides for severance
payments of up to 18 months of Ms. Lopez-Blanco&#146;s base salary plus, in certain cases, the payment of an amount equal to the greater of (x) the Average Annual Performance Bonus (as defined in the Employment Agreement) and (y) Ms.
Lopez-Blanco&#146;s bonus for the year immediately preceding her termination, and the continuation of certain fringe benefits for specified periods. In addition, depending on the basis for Ms. Lopez-Blanco&#146;s termination, all equity awards
granted to her by the Company prior to such termination will continue to vest until fully vested and, in certain termination events following a change in control of the Company, will be accelerated to become fully vested and payable. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Employment Agreement provides for customary protections of the Company&#146;s confidential information and intellectual property and that
Ms. Lopez-Blanco will not, during the term of her employment and for a period of 18 to 24 months thereafter, depending on the basis for termination, compete with the Company, hire away from or solicit to leave the Company its employees and
independent contractors, or interfere in the Company&#146;s relationships with its hospitals, other healthcare facilities, vendors, clients and other third parties. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Employment Agreement has a three year term and is subject to automatic renewals for successive one year terms. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The foregoing description of the Employment Agreement is qualified in its entirety by reference to the terms of the Employment Agreement, a
copy of which is attached to this Form 10-K as Exhibit 10.28 and is incorporated herein by reference. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">95 </P>


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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx463027_32"></A>PART III </B></P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx463027_14"></A>ITEM&nbsp;10.</B></TD>
<TD ALIGN="left" VALIGN="top"><B>DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE </B></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The information required by this
Item is incorporated by reference to the applicable information in the definitive proxy statement for our 2018 Annual Meeting of Shareholders, which is to be filed with the SEC within 120 days after our fiscal year end. </P>
<P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx463027_15"></A>ITEM&nbsp;11.</B></TD>
<TD ALIGN="left" VALIGN="top"><B>EXECUTIVE COMPENSATION </B></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The information required by this Item is incorporated by
reference to the applicable information in the definitive proxy statement for our 2018 Annual Meeting of Shareholders, which is to be filed with the SEC within 120 days after our fiscal year end. </P>
<P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx463027_16"></A>ITEM&nbsp;12.</B></TD>
<TD ALIGN="left" VALIGN="top"><B>SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND RELATED STOCKHOLDER MATTERS </B></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>SECURITIES AUTHORIZED FOR ISSUANCE UNDER EQUITY COMPENSATION PLANS </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following table provides information as of December&nbsp;31, 2017, with respect to shares of our common stock that may be issued under
existing equity compensation plans, including our Amended and Restated 2008 Incentive Compensation Plan, as amended (&#147;Amended and Restated 2008 Incentive Plan&#148;), our 2004 Incentive Compensation Plan, as amended (&#147;2004 Incentive
Plan&#148;), our ESPP and our SPP. </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="30%"></TD>
<TD VALIGN="bottom" WIDTH="18%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="18%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="18%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom" NOWRAP ALIGN="center"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-bottom:1.00pt solid #000000; width:49.10pt; display:inline; font-size:8pt; font-family:Times New Roman; " ALIGN="center"><B>Plan Category</B></P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Number&nbsp;of&nbsp;securities&nbsp;to&nbsp;be&nbsp;issued<BR>upon exercise of outstanding<BR>options, warrants and rights</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Weighted-average exercise<BR>price of outstanding<BR>options,&nbsp;warrants&nbsp;and&nbsp;rights</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Number&nbsp;of&nbsp;securities&nbsp;remaining<BR>available for future issuance<BR>under equity compensation<BR>plans (excluding securities<BR>reflected in
column (a))</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center"><B>(a)</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center"><B>(b)</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center"><B>(c)</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Equity compensation plans approved by security holders</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">246,342</TD>
<TD NOWRAP VALIGN="bottom">(1)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">27.51</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5,338,411</TD>
<TD NOWRAP VALIGN="bottom">(2)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Equity compensation plans not approved by security holders</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">N/A</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">N/A</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">N/A</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">246,342</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">27.51</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5,338,411</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">(1)</TD>
<TD ALIGN="left" VALIGN="top">All shares are issuable under the Amended and Restated 2008 Incentive Plan, as amended. </TD></TR></TABLE>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">(2)</TD>
<TD ALIGN="left" VALIGN="top">Under the Amended and Restated 2008 Incentive Plan, as amended, 3,400,093 shares remain available for future issuance, and under the ESPP and the SPP, an aggregate of 1,938,318 shares remain available for future
issuance. </TD></TR></TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The remaining information required by this Item is incorporated by reference to the applicable information in the
definitive proxy statement for our 2018 Annual Meeting of Shareholders, which is to be filed with the SEC within 120 days after our fiscal year end. </P> <P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx463027_17"></A>ITEM&nbsp;13.</B></TD>
<TD ALIGN="left" VALIGN="top"><B>CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS, AND DIRECTOR INDEPENDENCE </B></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The
information required by this Item is incorporated by reference to the applicable information in the definitive proxy statement for our 2018 Annual Meeting of Shareholders, which is to be filed with the SEC within 120 days after our fiscal year end.
</P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">96 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>



<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx463027_18"></A>ITEM&nbsp;14.</B></TD>
<TD ALIGN="left" VALIGN="top"><B>PRINCIPAL ACCOUNTING FEES AND SERVICES </B></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The information required by this Item is
incorporated by reference to the applicable information in the definitive proxy statement for our 2018 Annual Meeting of Shareholders, which is to be filed with the SEC within 120 days after our fiscal year end. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">97 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx463027_33"></A>PART IV </B></P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="9%" VALIGN="top" ALIGN="left"><B><A NAME="tx463027_19"></A>ITEM&nbsp;15.</B></TD>
<TD ALIGN="left" VALIGN="top"><B>EXHIBITS AND FINANCIAL STATEMENT SCHEDULE </B></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>(a)(1)&nbsp;&nbsp;&nbsp;&nbsp;Financial Statements
</B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The information required by this Item is included in Item 8 of Part II of this Form <FONT STYLE="white-space:nowrap">10-K.</FONT> </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>(a)(2)&nbsp;&nbsp;&nbsp;&nbsp;Financial Statement Schedule </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following financial statement schedule for the years ended December&nbsp;31, 2017, 2016 and 2015, is included in this Form <FONT
STYLE="white-space:nowrap">10-K</FONT> as set forth below (in thousands). </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx463027_27"></A>Schedule II: Valuation and Qualifying Accounts </B></P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="64%"></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2017</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2015</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Allowance for contractual adjustments and uncollectibles:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at beginning of year</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,224,366</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,129,301</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">848,767</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Amount charged against operating revenue</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">8,285,317</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">7,464,030</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6,389,195</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Accounts receivable contractual adjustments and write-offs (net of recoveries)</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(8,223,648</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(7,368,965</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(6,108,661</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at end of year</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,286,035</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,224,366</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,129,301</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">All other schedules have been omitted because they are not applicable, not required or the information is
included elsewhere herein. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>(a)(3) Exhibits </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">See Item 15(b) of this Form <FONT STYLE="white-space:nowrap">10-K.</FONT> </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>(b) Exhibits </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD></TD>
<TD VALIGN="bottom" WIDTH="9%"></TD>
<TD WIDTH="87%"></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;&nbsp;&nbsp;2.1</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312509000041/dex21.htm">Agreement and Plan of Merger, dated as of December<U></U>&nbsp;
29, 2008, between MEDNAX, Inc., Pediatrix Medical Group, Inc. and PMG Merger Sub, Inc. (incorporated by reference to Exhibit 2.1 to MEDNAX&#146;s Current Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated January<U></U>&nbsp;2, 2009).
</A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;&nbsp;&nbsp;3.1</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312514045903/d661956dex31.htm">Composite Articles of Incorporation of MEDNAX, Inc. (incorporated by reference to Exhibit 3.1 to MEDNAX&#146;s Annual Report on Form <FONT
STYLE="white-space:nowrap">10-K</FONT> for the period ended December<U></U>&nbsp;31, 2013). </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;&nbsp;&nbsp;3.2</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312509000041/dex33.htm">Amended and Restated <FONT STYLE="white-space:nowrap">By-laws</FONT> of MEDNAX, Inc. (incorporated by reference to Exhibit 3.3 to MEDNAX&#146;s Current
 Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated January<U></U>&nbsp;2, 2009). </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.1</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312515397783/d32768dex43.htm">Form of 5.25% Senior Notes due 2023 (incorporated by reference to Exhibit A of the First Supplemental Indenture filed as Exhibit 4.3 to MEDNAX&#146;s
 Current Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated December<U></U>&nbsp;8, 2015). </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.2</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312515397783/d32768dex42.htm">Indenture, dated as of December<U></U>&nbsp;
8, 2015, by and between MEDNAX, Inc. and U.S. Bank National Association, as Trustee. (incorporated by reference to Exhibit 4.2 to MEDNAX&#146;s Current Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated December<U></U>&nbsp;8, 2015).
</A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.3</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312515397783/d32768dex43.htm">First Supplemental Indenture dated as of December<U></U>&nbsp;8, 2015 to Indenture, dated as of December<U></U>&nbsp;
8, 2015, by and among MEDNAX, Inc., certain of its subsidiaries and U.S. Bank National Association, as Trustee. (incorporated by reference to Exhibit 4.3 to MEDNAX&#146;s Current Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated December
<U></U>&nbsp;8, 2015). </A></TD></TR></TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">98 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>



<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD WIDTH="87%"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>

<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.4+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d463027dex104.htm">Second Supplemental Indenture dated as of March&nbsp;30, 2017 to Indenture, dated as of December&nbsp;
8, 2015, by and among MEDNAX, Inc., certain of its subsidiaries and U.S. Bank National Association, as Trustee. </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.5+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d463027dex105.htm">Third Supplemental Indenture dated as of November&nbsp;9, 2017 to Indenture, dated as of December&nbsp;
8, 2015, by and among MEDNAX, Inc., certain of its subsidiaries and U.S. Bank National Association, as Trustee. </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.6</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312517329442/d240444dex101.htm">Credit Agreement, dated as of October<U></U>&nbsp;
30, 2017, among MEDNAX, Inc., certain of its domestic subsidiaries from time to time party thereto as Guarantors, the Lender parties thereto, JPMorgan Chase Bank, N.A. as Administrative Agent and Bank of America, N.A., Fifth Third Bank, Mizuho Bank, Ltd.,
 SunTrust Bank, The Bank of Tokyo-Mitsubishi UFJ, Ltd., and Wells Fargo Bank, National Association as Syndication Agents, and BBVA Compass, Citizens Bank, N.A., PNC Bank, Regions Bank, and U.S. Bank National Association, as Senior Documentation
Agents and BB&amp;T as Documentation Agent. JPMorgan Chase Bank, N.A, Fifth Third Bank, Merrill Lynch, Pierce, Fenner<U></U>&nbsp;&amp; Smith Incorporated, Mizuho Bank, Ltd., SunTrust Robinson Humphrey, Inc., The Bank of Tokyo-Mitsubishi UFJ, Ltd.,
and Wells Fargo Securities, LLC, acted as Joint Lead Arrangers and Joint Bookrunners. (incorporated by reference to Exhibit 10.1 to MEDNAX&#146;s Quarterly Report on Form <FONT STYLE="white-space:nowrap">10-Q</FONT> for the period ended
September<U></U>&nbsp;30, 2017).</A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.7</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014403009658/g84346exv10w5.txt">Amended and Restated Stock Option Plan of Pediatrix dated as of June<U></U>&nbsp;
4, 2003 (incorporated by reference to Exhibit 10.5 to Pediatrix&#146;s Quarterly Report on Form <FONT STYLE="white-space:nowrap">10-Q</FONT> for the period ended June<U></U>&nbsp;30, 2003).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.8</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312509000041/dex107.htm">First Amendment, dated December<U></U>&nbsp;
29, 2008, to Pediatrix Medical Group, Inc. Amended and Restated Stock Option Plan (incorporated by reference to Exhibit 10.7 to MEDNAX&#146;s Current Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated January<U></U>&nbsp;2, 2009).*
</A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.9</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312515323425/d62915ddef14a.htm">Amended and Restated MEDNAX, Inc. 1996 <FONT STYLE="white-space:nowrap">Non-Qualified</FONT> Employee Stock Purchase Plan (incorporated by reference
 to Exhibit A to MEDNAX&#146;s Definitive Proxy Statement on Schedule 14A, filed with the SEC on September<U></U>&nbsp;18, 2015).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.10</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312515323425/d62915ddef14a.htm">2015 <FONT STYLE="white-space:nowrap">Non-Qualified</FONT> Stock Purchase Plan of MEDNAX, Inc., dated September<U></U>&nbsp;
14, 2015 (incorporated by reference to Exhibit B to MEDNAX&#146;s Proxy Statement dated September<U></U>&nbsp;18, 2015).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.11</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/0001042910-98-000741.txt">Executive <FONT STYLE="white-space:nowrap">Non-Qualified</FONT> Deferred Compensation Plan of Pediatrix, dated October<U></U>&nbsp;
13, 1997 (incorporated by reference to Exhibit 10.35 to Pediatrix&#146;s Quarterly Report on Form <FONT STYLE="white-space:nowrap">10-Q</FONT> for the period ended June<U></U>&nbsp;30, 1998).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.12</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014402011954/g79340exv4w5.txt">Amended and Restated Thrift and Profit Sharing Plan of Pediatrix (incorporated by reference to Exhibit 4.5 to Pediatrix&#146;s Registration Statement
 on Form <FONT STYLE="white-space:nowrap">S-8</FONT> (Registration No.<U></U><FONT STYLE="white-space:nowrap">&nbsp;333-101222)).*</FONT> </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.13</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014404011924/g92297exv4w3.txt">Pediatrix Medical Group of Puerto Rico Thrift and Profit Sharing Plan (incorporated by reference to Exhibit 4.3 to Pediatrix&#146;s Registration
 Statement on Form <FONT STYLE="white-space:nowrap">S-8</FONT> dated December<U></U>&nbsp;9, 2004).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.14</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014404003687/x88020def14a.htm">Pediatrix Medical Group, Inc. 2004 Incentive Compensation Plan (incorporated by reference to Exhibit A of Pediatrix&#146;s Proxy Statement on Schedule
 14A dated April<U></U>&nbsp;9, 2004).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.15</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312509000041/dex108.htm">Second Amendment, dated December<U></U>&nbsp;
29, 2008, to Pediatrix Medical Group, Inc. 2004 Incentive Compensation Plan (incorporated by reference to Exhibit 10.8 to MEDNAX&#146;s Current Report on Form 8-K dated January<U></U>&nbsp;2, 2009).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.16</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312514058946/d679168dex101.htm">MEDNAX, Inc. Amended and Restated 2008 Incentive Compensation Plan, as amended (incorporated by reference to Exhibit 10.1 to MEDNAX&#146;s Current
 Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated February<U></U>&nbsp;19, 2014).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.17</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014405001776/g93013exv10w3.htm">Pediatrix Medical Group, Inc. Form of Stock Option Agreement for Stock Options Awarded Under the Amended and Restated Stock Option Plan (incorporated
 by reference to Exhibit 10.3 to Pediatrix&#146;s Current Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated February<U></U>&nbsp;23, 2005).* </A></TD></TR></TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">99 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>



<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD WIDTH="87%"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>

<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.18</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014405001776/g93013exv10w4.htm">Pediatrix Medical Group, Inc. Form of Incentive Stock Option Agreement for Incentive Stock Options Awarded Under the 2004 Incentive Compensation
 Plan (incorporated by reference to Exhibit 10.4 to Pediatrix&#146;s Current Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated February<U></U>&nbsp;23, 2005).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.19</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014405001776/g93013exv10w5.htm">Pediatrix Medical Group, Inc. Form of <FONT STYLE="white-space:nowrap">Non-Qualified</FONT> Stock Option Agreement for <FONT
STYLE="white-space:nowrap">Non-Qualified</FONT> Stock Options Awarded Under the 2004 Incentive Compensation Plan (incorporated by reference to Exhibit 10.5 to Pediatrix&#146;s Current Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated February
<U></U>&nbsp;23, 2005).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.20</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014405001776/g93013exv10w6.htm">Pediatrix Medical Group, Inc. Form of Restricted Stock Agreement for Restricted Stock Awarded Under the 2004 Incentive Compensation Plan (incorporated
 by reference to Exhibit 10.6 to Pediatrix&#146;s Current Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated February<U></U>&nbsp;23, 2005).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.21</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312509040133/dex1017.htm">MEDNAX, Inc. Form of <FONT STYLE="white-space:nowrap">Non-Qualified</FONT> Stock Option Agreement for <FONT STYLE="white-space:nowrap">Non-Qualified
</FONT> Stock Options Awarded Under the 2008 Incentive Compensation Plan (incorporated by reference to Exhibit 10.17 to MEDNAX&#146;s Annual Report on Form <FONT STYLE="white-space:nowrap">10-K</FONT> for the year ended December<U></U>&nbsp;31,
2008).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.22</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312509040133/dex1018.htm">MEDNAX, Inc. Form of Restricted Stock Agreement for Restricted Stock Awarded Under the 2008 Incentive Compensation Plan (incorporated by reference to
 Exhibit 10.18 to MEDNAX&#146;s Annual Report on Form <FONT STYLE="white-space:nowrap">10-K</FONT> for the year ended December<U></U>&nbsp;31, 2008).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.23</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312511217054/dex101.htm">Employment Agreement, dated August<U></U>&nbsp;
7, 2011, by and between MEDNAX Services, Inc. and Roger J. Medel, M.D. (incorporated by reference to Exhibit 10.1 to MEDNAX&#146;s Current Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated August<U></U>&nbsp;10, 2011).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.24</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312517303517/d470111dex101.htm">First Amendment to Employment Agreement, dated October&nbsp;
4, 2017, by and between MEDNAX Services, Inc. and Roger J. Medel, M.D. (incorporated by reference to Exhibit 10.1 to MEDNAX&#146;s Current Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated October&nbsp;4, 2017).*</A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.25</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312508182974/dex102.htm">Employment Agreement, dated August<U></U>&nbsp;
20, 2008, by and between Pediatrix Medical Group, Inc. and Joseph M. Calabro (incorporated by reference to Exhibit 10.2 to Pediatrix&#146;s Current Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated August<U></U>&nbsp;22, 2008).*
</A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.26</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312509000041/dex103.htm">Amendment Agreement, dated December<U></U>&nbsp;
29, 2008, between MEDNAX, Inc., Pediatrix Medical Group, Inc. and Joseph M. Calabro (incorporated by reference to Exhibit 10.3 to MEDNAX&#146;s Current Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated January<U></U>&nbsp;2, 2009).*
</A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.27</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312510040811/dex1028.htm">Employment Agreement, dated February<U></U>&nbsp;
24, 2010, by and between MEDNAX Services, Inc. and Vivian Lopez-Blanco (incorporated by reference to Exhibit 10.28 to MEDNAX&#146;s Annual Report on Form <FONT STYLE="white-space:nowrap">10-K</FONT> for the year ended December<U></U>&nbsp;
31, 2009).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.28+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d463027dex1028.htm">Employment Agreement, dated February&nbsp;12, 2018, by and between MEDNAX Services, Inc. and Vivian Lopez-Blanco.* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.29+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d463027dex1029.htm">Employment Agreement, dated February&nbsp;12, 2018, by and between MEDNAX Services, Inc. and Dominic J. Andreano.* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.30+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d463027dex1030.htm">Employment Agreement, dated February&nbsp;12, 2018, by and between MEDNAX Services, Inc. and David A. Clark.* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.31</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312511217054/dex102.htm">Restricted Shares Units Agreement for Roger J. Medel, M.D. dated August<U></U>&nbsp;
7, 2011 (incorporated by reference to Exhibit 10.2 to MEDNAX&#146;s Current Report on Form <FONT STYLE="white-space:nowrap">8-K</FONT> dated August<U></U>&nbsp;10, 2011).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.32</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014404002417/g87662exv10w6.txt">Form of Indemnification Agreement between Pediatrix and each of its directors and executive officers. (incorporated by reference to Exhibit 10.6
to Pediatrix&#146;s Annual Report on Form <FONT STYLE="white-space:nowrap">10-K</FONT> for the year ended December<U></U>&nbsp;31, 2003).* </A></TD></TR></TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">100 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>



<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD WIDTH="87%"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>

<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.33</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312512089192/d255020dex1031.htm">Form of Exclusive Management and Administrative Services Agreement with affiliated professional contractors (incorporated by reference to Exhibit
 10.31 to MEDNAX&#146;s Annual Report on Form <FONT STYLE="white-space:nowrap">10-K</FONT> for the year ended December<U></U>&nbsp;31, 2011). </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;21.1+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d463027dex211.htm">Subsidiaries of the Registrant. </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;23.1+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d463027dex231.htm">Consent of PricewaterhouseCoopers LLP. </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;31.1+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d463027dex311.htm">Certification of Chief Executive Officer pursuant to Securities Exchange Act Rule <FONT STYLE="white-space:nowrap">13a-14(a),</FONT> as adopted pursuant to Section&nbsp;
302 of the Sarbanes-Oxley Act of 2002. </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;31.2+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d463027dex312.htm">Certification of Chief Financial Officer pursuant to Securities Exchange Act Rule <FONT STYLE="white-space:nowrap">13a-14(a),</FONT> as adopted pursuant to Section&nbsp;
302 of the Sarbanes-Oxley Act of 2002. </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;32+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d463027dex32.htm">Certification pursuant to 18 U.S.C. Section&nbsp;1350, as adopted pursuant to Section&nbsp;906 of the Sarbanes-Oxley Act of 2002. </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>101.INS+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">XBRL Instance Document.</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>101.SCH+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">XBRL Taxonomy Extension Schema Document.</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>101.CAL+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">XBRL Taxonomy Extension Calculation Linkbase Document.</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>101.DEF+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">XBRL Taxonomy Extension Definition Linkbase Document.</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>101.LAB+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">XBRL Taxonomy Extension Label Linkbase Document.</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>101.PRE+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">XBRL Taxonomy Extension Presentation Linkbase Document.</TD></TR>
</TABLE> <P STYLE="line-height:8.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1px solid #000000;width:10%">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">*</TD>
<TD ALIGN="left" VALIGN="top">Management contracts or compensation plans, contracts or arrangements. </TD></TR></TABLE>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">+</TD>
<TD ALIGN="left" VALIGN="top">Filed herewith </TD></TR></TABLE> <P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx463027_20"></A>ITEM&nbsp;16.</B></TD>
<TD ALIGN="left" VALIGN="top"><B>FORM <FONT STYLE="white-space:nowrap">10-K</FONT> SUMMARY </B></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">None. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">101 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>SIGNATURES </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Pursuant to the requirements of Section&nbsp;13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this report to
be signed on its behalf by the undersigned, thereunto duly authorized. </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


<TR>
<TD WIDTH="45%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="5%"></TD>
<TD VALIGN="bottom"></TD>
<TD WIDTH="3%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="44%"></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3"><B>MEDNAX, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">Date: February&nbsp;14, 2018</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">By:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Roger J. Medel, M.D.</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Roger J. Medel, M.D.</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Chief Executive Officer</P></TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the
following persons on behalf of the registrant in the capacities and on the dates indicated. </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


<TR>
<TD WIDTH="38%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="40%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD WIDTH="18%"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom" NOWRAP ALIGN="center"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-bottom:1.00pt solid #000000; width:33.30pt; display:inline; font-size:8pt; font-family:Times New Roman; " ALIGN="center"><B>Signature</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" NOWRAP ALIGN="center"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-bottom:1.00pt solid #000000; width:15.95pt; display:inline; font-size:8pt; font-family:Times New Roman; " ALIGN="center"><B>Title</B></P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" NOWRAP ALIGN="center"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-bottom:1.00pt solid #000000; width:16.00pt; display:inline; font-size:8pt; font-family:Times New Roman; " ALIGN="center"><B>Date</B></P></TD></TR>


<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Roger J. Medel, M.D.</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Roger J. Medel, M.D.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">Chief Executive Officer</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">(Principal Executive Officer)</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2018</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Vivian Lopez-Blanco</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Vivian Lopez-Blanco</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">Chief Financial Officer and Treasurer</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">(Principal Financial Officer)</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2018</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ John C. Pepia</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">John C. Pepia</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">Chief Accounting Officer</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">(Principal Accounting Officer)</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2018</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Cesar L. Alvarez</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Cesar L. Alvarez</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Director and Chairman of the Board</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2018</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Manuel Kadre</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Manuel Kadre</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Lead Independent Director</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2018</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Karey D. Barker</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Karey D. Barker</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Director</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2018</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Waldemar A. Carlo, M.D.</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Waldemar A. Carlo, M.D.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Director</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2018</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Michael B. Fernandez</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Michael B. Fernandez</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Director</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2018</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Paul G. Gabos</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Paul G. Gabos</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Director</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2018</TD></TR>
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<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Pascal J. Goldschmidt, M.D.</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Pascal J. Goldschmidt, M.D.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Director</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2018</TD></TR>
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<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Donna E. Shalala, Ph.D.</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Donna E. Shalala, Ph.D.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Director</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2018</TD></TR>
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<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Enrique J. Sosa, Ph.D.</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Enrique J. Sosa, Ph.D.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Director</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2018</TD></TR>
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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="right"><B>Exhibit 10.4 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>TO
</B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>U.S. BANK NATIONAL ASSOCIATION, </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>as Trustee </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>GUARANTEED
TO THE EXTENT SET FORTH HEREIN BY THE GUARANTORS NAMED HEREIN </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>SECOND SUPPLEMENTAL INDENTURE </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Dated as of March&nbsp;30, 2017 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>to the </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>INDENTURE
</B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Dated as of December&nbsp;8, 2015 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>GUARANTEES OF 5.25% SENIOR NOTES DUE 2023 </B></P>

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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>SECOND SUPPLEMENTAL INDENTURE </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>5.25% Senior Notes due 2023 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">THIS SECOND SUPPLEMENTAL INDENTURE, dated as of March&nbsp;30, 2017 (this &#147;<B>Second Supplemental Indenture</B>&#148;), by and among
MEDNAX, INC., a Florida Corporation (the &#147;<B>Company</B>&#148;), the guarantors listed on <U>Schedule A</U> hereto (collectively, the &#147;<B>Guarantors</B>&#148; and each, a &#147;<B>Guarantor</B>&#148;), and U.S. Bank National Association, a
national banking association, as Trustee hereunder (the &#147;<B>Trustee</B>&#148;). </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>RECITALS OF THE COMPANY: </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, the Company and the Trustee have heretofore entered into an Indenture dated as of December&nbsp;8, 2015 (the &#147;<B>Base
Indenture</B>&#148;), as supplemented by the First Supplemental Indenture, dated as of December&nbsp;8, 2015 (the &#147;<B>First Supplemental Indenture</B>&#148; and, together with the Base Indenture and this Second Supplemental Indenture, the
&#147;<B>Indenture</B>&#148;) providing for the issuance by the Company of $750,000,000 aggregate principal amount of its 5.25% Senior Notes due 2023 (together with the Guarantees thereof, the &#147;<B>Notes</B>&#148;); </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, Section&nbsp;4.04 of the First Supplemental Indenture provides that if the Company or any of its Subsidiaries acquires or creates
another Subsidiary after the Issue Date that provides a guarantee of the Company&#146;s obligations under any Debt Facility (including the Credit Agreement) with an aggregate principal or committed amount of $250&nbsp;million or more, then, within
10 Business Days after such Subsidiary provides such guarantee, such newly acquired or created Subsidiary shall execute a supplemental indenture pursuant to which it will unconditionally Guarantee, on a joint and several basis, payment of principal
of, premium, if any, and interest in respect of the Notes on a senior unsecured basis on the same terms and conditions as those set forth in the First Supplemental Indenture; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, each of the Guarantors is a newly acquired or created Subsidiary of the Company and has provided a guarantee of the Company&#146;s
obligations under the Credit Agreement pursuant to that certain Joinder Agreement, dated as of March&nbsp;30, 2017; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS,
Section&nbsp;6.01 of the First Supplemental Indenture provides that the Company, the Guarantors, if applicable, and the Trustee may modify and amend the Indenture, the Notes or the Guarantees of the Notes without the consent of any Holder to allow
any Guarantor to execute a supplemental indenture and/or a Guarantee of the Notes; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, the Board of Directors of the Company and the
governing bodies of each of the Guarantors has duly authorized the execution and delivery of this Second Supplemental Indenture; and </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, all acts and things necessary to make this Second Supplemental Indenture a valid agreement of each of the Company and the Guarantors
according to its terms have been done and performed. </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>NOW THEREFORE, SECOND SUPPLEMENTAL INDENTURE WITNESSETH: </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">For and in consideration of the premises and of the covenants contained herein, in the Base Indenture and the First Supplemental Indenture,
the Company, the Guarantors and the Trustee covenant </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">1 </P>


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and agree, for the equal and proportionate benefit of all Holders of the Notes issued prior to or after the date of this Second Supplemental Indenture, as follows: </P>
<P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE I </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>RELATION TO
BASE INDENTURE; DEFINITIONS </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;1.01.&nbsp;&nbsp;&nbsp;&nbsp;<U>Relation to Base Indenture</U>. The changes, modifications
and supplements to the Base Indenture effected by this Second Supplemental Indenture shall be applicable only with respect to, and shall only govern the terms of, the Notes, which may be issued from time to time, and shall not apply to any other
Securities that may be issued under the Base Indenture unless a supplemental indenture with respect to such other Securities specifically incorporates such changes, modifications and supplements. The provisions of this Second Supplemental Indenture
shall supersede any corresponding or conflicting provisions and definitions in the Base Indenture. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;1.02.&nbsp;&nbsp;&nbsp;&nbsp;<U>Definitions</U>. For all purposes of this Second Supplemental Indenture, except as otherwise
expressly provided for or unless the context otherwise requires: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a)&nbsp;&nbsp;&nbsp;&nbsp;Capitalized terms used but not
defined herein shall have the respective meanings assigned to them in the Base Indenture and the First Supplemental Indenture; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b)&nbsp;&nbsp;&nbsp;&nbsp;Terms defined both in the Base Indenture and in the First Supplemental Indenture shall have the
meanings assigned to them in the First Supplemental Indenture; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c)&nbsp;&nbsp;&nbsp;&nbsp;Terms defined both herein and in
the Base Indenture or First Supplemental Indenture shall have the meanings assigned to them herein; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d)&nbsp;&nbsp;&nbsp;&nbsp;All references herein to Articles and Sections, unless otherwise specified, refer to the
corresponding Articles and Sections of this Second Supplemental Indenture; and </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e)&nbsp;&nbsp;&nbsp;&nbsp;All other terms
used in this Second Supplemental Indenture, which are defined in the Trust Indenture Act or which are by reference therein defined in the Securities Act (except as herein otherwise expressly provided or unless the context otherwise requires) shall
have the meanings assigned to such terms in said Trust Indenture Act and in said Securities Act as in force at the date of the execution of this Second Supplemental Indenture. The words &#147;herein,&#148; &#147;hereof,&#148; &#147;hereunder,&#148;
and words of similar import refer to this Second Supplemental Indenture as a whole and not to any particular Article, Section or other subdivision. The terms defined in this Article include the plural as well as the singular. </P>
<P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE II </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>GUARANTEES
</B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.01.&nbsp;&nbsp;&nbsp;&nbsp;<U>Guarantee</U>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(a)&nbsp;&nbsp;&nbsp;&nbsp;Subject to this Article II, each of the Guarantors hereby, jointly and severally, unconditionally guarantees on an
unsecured, unsubordinated basis, to each Holder of a Note, authenticated and delivered by the Trustee, and to the Trustee and its successors and assigns, irrespective of the validity and enforceability of this Second Supplemental Indenture, First
Supplemental Indenture or the Base Indenture, the Notes or the obligations of the Company hereunder or thereunder, that: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i)&nbsp;&nbsp;&nbsp;&nbsp;the principal of, premium, if any, and interest on, the Notes will be promptly paid in full when
due, whether at maturity, by acceleration or otherwise, and interest on the overdue principal and interest on the Notes, if any, if lawful, and all other obligations of the Company to the Holders or the Trustee hereunder or thereunder will be
promptly paid in full or performed, all in accordance with the terms hereof and thereof; and </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">2 </P>


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 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii)&nbsp;&nbsp;&nbsp;&nbsp;in case of any extension of time of payment or
renewal of any Notes or any of such other obligations, that same will be promptly paid in full when due or performed in accordance with the terms of the extension or renewal, whether at Stated Maturity, by acceleration or otherwise. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Failing payment when due of any amount so guaranteed or any performance so guaranteed for any reason whatsoever, the Guarantors shall be jointly and severally
obligated to pay the same immediately. Each Guarantor agrees that this is a guarantee of payment and not a guarantee of collection. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(a)&nbsp;&nbsp;&nbsp;&nbsp;The Guarantors hereby agree that their obligations hereunder are unconditional, irrespective of the validity,
regularity or enforceability of this Second Supplemental Indenture, the First Supplemental Indenture, or the Base Indenture, the Notes, the absence of any action to enforce the same, any waiver or consent by any Holder of the Notes with respect to
any provisions hereof or thereof, the recovery of any judgment against the Company, any action to enforce the same or any other circumstance which might otherwise constitute a legal or equitable discharge or defense of a Guarantor. Each Guarantor
hereby waives diligence, presentment, demand of payment, filing of claims with a court in the event of bankruptcy or insolvency of the Company, any right to require a proceeding first against the Company, protest, notice and all demands whatsoever
and covenant that this Guarantee will not be discharged except by complete performance of the obligations contained in the Notes and the Indenture. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(b)&nbsp;&nbsp;&nbsp;&nbsp;If any Holder or the Trustee is required by any court or otherwise to return to the Company, the Guarantors or any
custodian, trustee, liquidator or other similar official acting in relation to either the Company or the Guarantors, any amount paid either to the Trustee or such Holder, this Guarantee, to the extent theretofore discharged, shall be reinstated in
full force and effect. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(c)&nbsp;&nbsp;&nbsp;&nbsp;Each Guarantor agrees that it shall not be entitled to any right of subrogation in
relation to the Holders in respect of any obligations guaranteed hereby until payment in full of all obligations under the Notes guaranteed hereby. Each Guarantor further agrees that, as between the Guarantors, on the one hand, and the Holders and
the Trustee, on the other hand, (1)&nbsp;the maturity of the obligations guaranteed hereby may be accelerated as provided in Article V of the First Supplemental Indenture for the purposes of this Guarantee, notwithstanding any stay, injunction or
other prohibition preventing such acceleration in respect of the obligations guaranteed hereby, and (2)&nbsp;in the event of any declaration of acceleration of such obligations as provided in Article V of the First Supplemental Indenture, such
obligations (whether or not due and payable) will forthwith become due and payable by the Guarantors for purposes of this Guarantee. The Guarantors will have the right to seek contribution from any other Guarantor, or the Company, as the case may
be, so long as the exercise of such right does not impair the rights of the Holders under this Guarantee. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.02.&nbsp;&nbsp;&nbsp;&nbsp;<U>Limitation on Guarantor Liability</U>. Each Guarantor, and by its acceptance of the Notes, each
Holder, hereby confirms that it is the intention of all such parties that the Guarantee of such Guarantor of the Notes not constitute a fraudulent transfer, fraudulent conveyance or fraudulent obligation for purposes of Bankruptcy Law, the Uniform
Fraudulent Conveyance Act, the Uniform Fraudulent Transfer Act or any similar federal or state law to the extent applicable to any Guarantee of the Notes. To effectuate the foregoing intention, the Trustee, the Holders and the Guarantors hereby
irrevocably agree that the obligations of such Guarantor shall be limited to the maximum amount that shall, after giving effect to such maximum amount and all other contingent and fixed liabilities of such Guarantor that are relevant under such
laws, and after giving effect to any collections from, rights to receive contributions from or payments made by or on behalf of any other Guarantor in respect of the obligations of such other Guarantor under this Article II that are relevant under
such laws, result in the obligations of such Guarantor under its Guarantee of the Notes not constituting a fraudulent transfer, fraudulent conveyance or fraudulent obligation. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">3 </P>


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 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.03.&nbsp;&nbsp;&nbsp;&nbsp;<U>Execution and Delivery of Guarantees</U>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(a)&nbsp;&nbsp;&nbsp;&nbsp;To evidence its Guarantee as set forth in Section&nbsp;2.01 hereof, each Guarantor hereby agrees that this Second
Supplemental Indenture shall be executed on behalf of such Guarantor by one of its authorized officers or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">attorneys-in-fact.</FONT></FONT> </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(b)&nbsp;&nbsp;&nbsp;&nbsp;Each Guarantor hereby agrees that its Guarantee set forth in Section&nbsp;2.01 hereof shall remain in full force
and effect notwithstanding the absence of the endorsement of any notation of such Guarantee. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.04.&nbsp;&nbsp;&nbsp;&nbsp;<U>Contribution</U>. Each Guarantor that makes a payment or distribution under its Guarantee of the
Notes shall be entitled to contribution from any other Guarantor or the Company, as the case may be. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.05.&nbsp;&nbsp;&nbsp;&nbsp;<U>Releases</U>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(a)&nbsp;&nbsp;&nbsp;&nbsp;The Guarantee of the Notes by a Guarantor will be automatically and unconditionally released, and any Person
acquiring assets (including by way of merger or consolidation) or Capital Stock of a Guarantor shall not be required to assume the obligations of any such Guarantor: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(1)&nbsp;&nbsp;&nbsp;&nbsp;in connection with any sale, exchange, transfer, conveyance or other disposition of (whether by
merger, consolidation or the sale of) a majority of the Capital Stock of such Guarantor (or such lesser portion as is sufficient for such Guarantor to cease to be a Subsidiary of the Company) or the sale of all or substantially all the assets of
such Guarantor, to or with and into a Person which is not the Company or another Subsidiary of the Company; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(2)&nbsp;&nbsp;&nbsp;&nbsp;if any Guarantor is dissolved or otherwise no longer obligated to provide a Guarantee of the Notes
pursuant to the Indenture; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(3)&nbsp;&nbsp;&nbsp;&nbsp;if such Guarantor&#146;s guarantee of any obligations under any Debt
Facility of the Company (including the Credit Agreement) with an aggregate principal or committed amount of $250&nbsp;million or more is fully and unconditionally released, except that such Guarantor shall subsequently be required to become a
Guarantor by executing a supplemental indenture and providing the Trustee with an Officer&#146;s Certificate and Opinion of Counsel as required by the Indenture at such time as it guarantees any obligations under any Debt Facility of the Company
(including the Credit Agreement) with an aggregate principal or committed amount of $250&nbsp;million or more; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(4)&nbsp;&nbsp;&nbsp;&nbsp;upon the Company&#146;s exercise of its legal defeasance option or covenant defeasance option as
described in Section&nbsp;12.02 or Section&nbsp;12.03 of the First Supplemental Indenture or if the Company&#146;s obligations under the Indenture and the Notes are discharged in accordance with Section&nbsp;12.01 of the First Supplemental
Indenture. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(b)&nbsp;&nbsp;&nbsp;&nbsp;The Trustee shall execute any documents reasonably requested by either the Company or a Guarantor
in order to evidence the release of such Guarantor from its obligations under its Guarantee under this Article II, subject to the Trustee&#146;s receipt of an Opinion of Counsel and Officer&#146;s Certificates stating that all conditions precedent
to such release have been met. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">4 </P>


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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE III </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MISCELLANEOUS PROVISIONS </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.01.&nbsp;&nbsp;&nbsp;&nbsp;<U>Ratification of Base Indenture</U>. Except as expressly modified or amended hereby, the Indenture
continues in full force and effect and is in all respects confirmed, ratified and preserved and the provisions thereof shall be applicable to the Notes and this Second Supplemental Indenture. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.02.&nbsp;&nbsp;&nbsp;&nbsp;<U>Provisions Binding on Company</U><U>&#146;</U><U>s Successors</U>. All the covenants,
stipulations, promises and agreements of the Company contained in this Second Supplemental Indenture shall bind its successors and assigns whether so expressed or not. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.03.&nbsp;&nbsp;&nbsp;&nbsp;<U>Official Acts by Successor Corporation</U>. Any act or proceeding by any provision of this Second
Supplemental Indenture authorized or required to be done or performed by any board, committee or officer of the Company shall and may be done and performed with like force and effect by the like board, committee or officer of any corporation or
entity that shall at the time be the lawful sole successor of the Company. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.04.&nbsp;&nbsp;&nbsp;&nbsp;<U>Addresses for
Notices, Etc</U>. Any notice or demand which by any provision of this Second Supplemental Indenture is required or permitted to be given or served by the Trustee or by the Noteholders on the Company or the Guarantors shall be deemed to have been
sufficiently given or made, for all purposes if given or served by being deposited postage prepaid by registered or certified mail in a post office letter box addressed (until another address is filed by the Company with the Trustee) to the Company
at 1301 Concord Terrace, Sunrise, Florida 33323, Attention: General Counsel. Any notice, direction, request or demand hereunder to or upon the Trustee shall be deemed to have been sufficiently given or made, for all purposes, if given or served by
being deposited postage prepaid by registered or certified mail in a post office letter box addressed to U.S. Bank National Association at 1349 W. Peachtree Street, Suite 1050, Atlanta, Georgia 30309, Attention: George Hogan. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Trustee, by notice to the Company, may designate additional or different addresses for subsequent notices or communications. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Any notice or communication mailed to a Noteholder shall be mailed to him by first class mail, postage prepaid, at his address as it appears
on the Security Register and shall be sufficiently given to him if so mailed within the time prescribed. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Failure to mail a notice or
communication to a Noteholder or any defect in it shall not affect its sufficiency with respect to other Noteholders. If a notice or communication is mailed in the manner provided above, it is duly given, whether or not the addressee receives it.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.05.&nbsp;&nbsp;&nbsp;&nbsp;<U>Governing Law</U>. THIS SECOND SUPPLEMENTAL INDENTURE SHALL BE GOVERNED BY AND CONSTRUED IN
ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK WITHOUT REGARD TO CONFLICT OF LAWS PRINCIPLES OF SUCH STATE OTHER THAN NEW YORK GENERAL OBLIGATIONS LAW SECTION <FONT STYLE="white-space:nowrap">5-1401.</FONT> THIS SECOND SUPPLEMENTAL INDENTURE IS
SUBJECT TO THE PROVISIONS OF THE TIA THAT ARE REQUIRED TO BE A PART OF THIS SECOND SUPPLEMENTAL INDENTURE AND SHALL, TO THE EXTENT APPLICABLE, BE GOVERNED BY SUCH PROVISIONS. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.06.&nbsp;&nbsp;&nbsp;&nbsp;<U>Benefits of Indenture</U>. Nothing in the Indenture or in the Notes, expressed or implied, shall
give to any person, other than the parties hereto, any Paying Agent, any authenticating agent, any Security Registrar and their successors hereunder, the Noteholders, any benefit or any legal or equitable right, remedy or claim under the Indenture.
</P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">5 </P>


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 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.07.&nbsp;&nbsp;&nbsp;&nbsp;<U>Headings, Etc</U>. The titles and headings of the
articles and sections of this Second Supplemental Indenture have been inserted for convenience of reference only, are not to be considered a part hereof, and shall in no way modify or restrict any of the terms or provisions hereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.08.&nbsp;&nbsp;&nbsp;&nbsp;<U>Counterparts</U>. This Second Supplemental Indenture may be executed and delivered in any number
of counterparts, each of which when so executed and delivered shall be deemed to be an original, and all such counterparts shall together constitute but one and the same instrument. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.09.&nbsp;&nbsp;&nbsp;&nbsp;<U>Trustee</U>. The Trustee makes no representations as to the validity or sufficiency of this
Second Supplemental Indenture. The statements and recitals herein are deemed to be those of the Company and not of the Trustee. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.10.&nbsp;&nbsp;&nbsp;&nbsp;<U>Further Instruments and Acts</U>. Upon request of the Trustee, the Company will execute and
deliver such further instruments and do such further acts as may be reasonably necessary or proper to carry out more effectively the purposes of this Second Supplemental Indenture. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.11.&nbsp;&nbsp;&nbsp;&nbsp;<U>Waiver of Jury Trial</U>. EACH OF THE COMPANY, THE GUARANTORS AND THE TRUSTEE HEREBY IRREVOCABLY
WAIVES, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, ANY AND ALL RIGHT TO TRIAL BY JURY IN ANY LEGAL PROCEEDING ARISING OUT OF OR RELATING TO THE INDENTURE, THE NOTES OR THE TRANSACTION CONTEMPLATED HEREBY. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><I>[Remainder of page left intentionally blank] </I></B></P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">6 </P>


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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>IN WITNESS WHEREOF</B>, the parties hereto have caused this Second Supplemental Indenture to be duly executed
by their respective officers hereunto duly authorized, all as of the day and year first above written. </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


<TR>
<TD WIDTH="46%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="2%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="4%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="45%"></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">COMPANY:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>MEDNAX, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">By:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"> <P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;/s/ Vivian Lopez-Blanco</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Name:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Vivian Lopez-Blanco</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Title:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Chief Financial Officer and Treasurer</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">TRUSTEE:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>U.S. BANK NATIONAL ASSOCIATION</B>,<B></B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">By:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"> <P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;/s/ George Hogan</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Name:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">George Hogan</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Title:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Vice-President</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">GUARANTORS:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>AMERICAN ANESTHESIOLOGY OF MINNESOTA, P.A.</B>, a Minnesota professional corporation</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>AMERICAN ANESTHESIOLOGY OF NAPLES, INC.</B>, a Florida corporation</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>AMERICAN ANESTHESIOLOGY OF SOUTH CAROLINA, LLC</B>, a South Carolina limited liability company</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>AMERICAN ANESTHESIOLOGY SERVICES OF FLORIDA, INC.</B>, a Florida corporation</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>CARDON HEALTHCARE NETWORK, LLC</B>, a Delaware limited liability company</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>DIVERSIFIED HEALTHCARE RESOURCES, LLC</B>, a California limited liability company</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">By:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"> <P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">&nbsp;&nbsp;/s/ Dominic J. Andreano</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5">Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">Attorney-in-Fact</FONT></FONT> of each of the foregoing</TD></TR>
</TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><I>[Second Supplemental
Indenture &#151; Signature Page] </I></P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">



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<TD WIDTH="46%"></TD>
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<TD WIDTH="4%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="2%"></TD>
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<TD WIDTH="45%"></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">GUARANTORS&nbsp;(cont&#146;d):</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3"><B></B><B>DUET HEALTH, INC.</B>, a Delaware corporation</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3"><B>INFINITY MANAGEMENT, LLC</B>, a Tennessee limited liability company</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3"><B>PATIENT ADVOCATE TECHNOLOGY, LLC</B>, a Delaware limited liability company</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3"><B>PICKERT MEDICAL GROUP, P.C.</B>, a Nevada professional corporation</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3"><B>RADIOLOGY ALLIANCE, P.C.</B>, a Tennessee professional corporation</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3"><B>SPECIALTY MRI, LLC</B>, a Tennessee limited liability company</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3"><B>WESTCHESTER ANESTHESIOLOGISTS, P.C.</B>, a New York professional corporation</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">By:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">&nbsp;&nbsp;/s/ Dominic&nbsp;J.&nbsp;Andreano</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3">Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">Attorney-in-Fact</FONT></FONT> of each of the foregoing</TD></TR>
</TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><I>[Second Supplemental
Indenture &#151; Signature Page] </I></P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">


 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><U>Schedule A </U></B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Guarantors </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">1.</TD>
<TD ALIGN="left" VALIGN="top">American Anesthesiology of Minnesota, P.A. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">2.</TD>
<TD ALIGN="left" VALIGN="top">American Anesthesiology of Naples, Inc. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">3.</TD>
<TD ALIGN="left" VALIGN="top">American Anesthesiology of South Carolina, LLC </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">4.</TD>
<TD ALIGN="left" VALIGN="top">American Anesthesiology Services of Florida, Inc. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">5.</TD>
<TD ALIGN="left" VALIGN="top">Cardon Healthcare Network, LLC </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">6.</TD>
<TD ALIGN="left" VALIGN="top">Diversified Healthcare Resources, LLC </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">7.</TD>
<TD ALIGN="left" VALIGN="top">Duet Health, Inc. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">8.</TD>
<TD ALIGN="left" VALIGN="top">Infinity Management, LLC </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">9.</TD>
<TD ALIGN="left" VALIGN="top">Patient Advocate Technology, LLC </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">10.</TD>
<TD ALIGN="left" VALIGN="top">Pickert Medical Group, P.C. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">11.</TD>
<TD ALIGN="left" VALIGN="top">Radiology Alliance, P.C. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">12.</TD>
<TD ALIGN="left" VALIGN="top">Specialty MRI, LLC </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">13.</TD>
<TD ALIGN="left" VALIGN="top">Westchester Anesthesiologists, P.C. </TD></TR></TABLE>
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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="right"><B>Exhibit 10.5 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>TO
</B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>U.S. BANK NATIONAL ASSOCIATION, </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>as Trustee </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>GUARANTEED
TO THE EXTENT SET FORTH HEREIN BY THE GUARANTORS NAMED HEREIN </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>THIRD SUPPLEMENTAL INDENTURE </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Dated as of November&nbsp;9, 2017 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>to the </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>INDENTURE
</B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Dated as of December&nbsp;8, 2015 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>GUARANTEES OF 5.25% SENIOR NOTES DUE 2023 </B></P>

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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>THIRD SUPPLEMENTAL INDENTURE </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>5.25% Senior Notes due 2023 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">THIS THIRD SUPPLEMENTAL INDENTURE, dated as of November&nbsp;9, 2017 (this &#147;<B>Third Supplemental Indenture</B>&#148;), by and among
MEDNAX, INC., a Florida Corporation (the &#147;<B>Company</B>&#148;), the guarantors listed on <U>Schedule A</U> hereto (collectively, the &#147;<B>Guarantors</B>&#148; and each, a &#147;<B>Guarantor</B>&#148;), and U.S. Bank National Association, a
national banking association, as Trustee hereunder (the &#147;<B>Trustee</B>&#148;). </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>RECITALS OF THE COMPANY: </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, the Company and the Trustee have heretofore entered into an Indenture dated as of December&nbsp;8, 2015 (the &#147;<B>Base
Indenture</B>&#148;), as supplemented by the First Supplemental Indenture, dated as of December&nbsp;8, 2015 (the &#147;<B>First Supplemental Indenture</B>&#148;) and the Second Supplemental Indenture, dated as of March&nbsp;30, 2017 (the
&#147;<B>Second Supplemental Indenture</B>&#148; and, together with the Base Indenture, First Supplemental Indenture and this Third Supplemental Indenture, the &#147;<B>Indenture</B>&#148;) providing for the issuance by the Company of $750,000,000
aggregate principal amount of its 5.25% Senior Notes due 2023 (together with the Guarantees thereof, the &#147;<B>Notes</B>&#148;); </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, Section&nbsp;4.04 of the First Supplemental Indenture provides that if the Company or any of its Subsidiaries acquires or creates
another Subsidiary after the Issue Date that provides a guarantee of the Company&#146;s obligations under any Debt Facility (including the New Credit Agreement (hereinafter defined)) with an aggregate principal or committed amount of
$250&nbsp;million or more, then, within 10 Business Days after such Subsidiary provides such guarantee, such newly acquired or created Subsidiary shall execute a supplemental indenture pursuant to which it will unconditionally Guarantee, on a joint
and several basis, payment of principal of, premium, if any, and interest in respect of the Notes on a senior unsecured basis on the same terms and conditions as those set forth in the First Supplemental Indenture; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, each of the Guarantors is a newly acquired or created Subsidiary of the Company and has provided a guarantee of the Company&#146;s
obligations under that certain Credit Agreement, dated as of October&nbsp;30, 2017, by and among the Company, the guarantors party thereto, JPMorgan Chase Bank, N.A., in its capacity as administrative agent, and the lenders party thereto (the
&#147;<B>New Credit Agreement</B>&#148;), which New Credit Agreement has replaced the Credit Agreement; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, Section&nbsp;6.01 of the
First Supplemental Indenture provides that the Company, the Guarantors, if applicable, and the Trustee may modify and amend the Indenture, the Notes or the Guarantees of the Notes without the consent of any Holder to allow any Guarantor to execute a
supplemental indenture and/or a Guarantee of the Notes; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, the Board of Directors of the Company and the governing bodies of each
of the Guarantors has duly authorized the execution and delivery of this Third Supplemental Indenture; and </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, all acts and things
necessary to make this Third Supplemental Indenture a valid agreement of each of the Company and the Guarantors according to its terms have been done and performed. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">1 </P>


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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>NOW THEREFORE, THIRD SUPPLEMENTAL INDENTURE WITNESSETH: </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">For and in consideration of the premises and of the covenants contained herein, in the Base Indenture, the First Supplemental Indenture and
the Second Supplemental Indenture, the Company, the Guarantors and the Trustee covenant and agree, for the equal and proportionate benefit of all Holders of the Notes issued prior to or after the date of this Third Supplemental Indenture, as
follows: </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE I </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>RELATION TO BASE INDENTURE; DEFINITIONS </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;1.01.&nbsp;&nbsp;&nbsp;&nbsp;<U>Relation to Base Indenture</U>. The changes, modifications and supplements to the Base Indenture
effected by this Third Supplemental Indenture shall be applicable only with respect to, and shall only govern the terms of, the Notes, which may be issued from time to time, and shall not apply to any other Securities that may be issued under the
Base Indenture unless a supplemental indenture with respect to such other Securities specifically incorporates such changes, modifications and supplements. The provisions of this Third Supplemental Indenture shall supersede any corresponding or
conflicting provisions and definitions in the Base Indenture. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;1.02.&nbsp;&nbsp;&nbsp;&nbsp;<U>Definitions</U>. For all
purposes of this Third Supplemental Indenture, except as otherwise expressly provided for or unless the context otherwise requires: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a)&nbsp;&nbsp;&nbsp;&nbsp;Capitalized terms used but not defined herein shall have the respective meanings assigned to them in
the Base Indenture, the First Supplemental Indenture and the Second Supplemental Indenture; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b)&nbsp;&nbsp;&nbsp;&nbsp;Terms defined both in the Base Indenture and in the First Supplemental Indenture or in the Second
Supplemental Indenture shall have the meanings assigned to them in the First Supplemental Indenture; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c)&nbsp;&nbsp;&nbsp;&nbsp;Terms defined herein and in the Base Indenture, in the First Supplemental Indenture, or in the
Second Supplemental Indenture shall have the meanings assigned to them herein; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d)&nbsp;&nbsp;&nbsp;&nbsp;All references
herein to Articles and Sections, unless otherwise specified, refer to the corresponding Articles and Sections of this Third Supplemental Indenture; and </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e)&nbsp;&nbsp;&nbsp;&nbsp;All other terms used in this Third Supplemental Indenture, which are defined in the Trust Indenture
Act or which are by reference therein defined in the Securities Act (except as herein otherwise expressly provided or unless the context otherwise requires) shall have the meanings assigned to such terms in said Trust Indenture Act and in said
Securities Act as in force at the date of the execution of this Third Supplemental Indenture. The words &#147;herein,&#148; &#147;hereof,&#148; &#147;hereunder,&#148; and words of similar import refer to this Third Supplemental Indenture as a whole
and not to any particular Article, Section or other subdivision. The terms defined in this Article include the plural as well as the singular. </P>
<P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE II </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>GUARANTEES
</B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.01.&nbsp;&nbsp;&nbsp;&nbsp;<U>Guarantee</U>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(a)&nbsp;&nbsp;&nbsp;&nbsp;Subject to this Article II, each of the Guarantors hereby, jointly and severally, unconditionally guarantees on an
unsecured, unsubordinated basis, to each Holder of a Note, authenticated and delivered by the Trustee, and to the Trustee and its successors and assigns, irrespective </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">2 </P>


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of the validity and enforceability of this Third Supplemental Indenture, the Second Supplemental Indenture, the First Supplemental Indenture or the Base Indenture, the Notes or the obligations of
the Company hereunder or thereunder, that: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i)&nbsp;&nbsp;&nbsp;&nbsp;the principal of, premium, if any, and interest on,
the Notes will be promptly paid in full when due, whether at maturity, by acceleration or otherwise, and interest on the overdue principal and interest on the Notes, if any, if lawful, and all other obligations of the Company to the Holders or the
Trustee hereunder or thereunder will be promptly paid in full or performed, all in accordance with the terms hereof and thereof; and </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii)&nbsp;&nbsp;&nbsp;&nbsp;in case of any extension of time of payment or renewal of any Notes or any of such other
obligations, that same will be promptly paid in full when due or performed in accordance with the terms of the extension or renewal, whether at Stated Maturity, by acceleration or otherwise. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Failing payment when due of any amount so guaranteed or any performance so guaranteed for any reason whatsoever, the Guarantors shall be jointly and severally
obligated to pay the same immediately. Each Guarantor agrees that this is a guarantee of payment and not a guarantee of collection. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(a)&nbsp;&nbsp;&nbsp;&nbsp;The Guarantors hereby agree that their obligations hereunder are unconditional, irrespective of the validity,
regularity or enforceability of this Third Supplemental Indenture, the Second Supplemental Indenture, the First Supplemental Indenture, or the Base Indenture, the Notes, the absence of any action to enforce the same, any waiver or consent by any
Holder of the Notes with respect to any provisions hereof or thereof, the recovery of any judgment against the Company, any action to enforce the same or any other circumstance which might otherwise constitute a legal or equitable discharge or
defense of a Guarantor. Each Guarantor hereby waives diligence, presentment, demand of payment, filing of claims with a court in the event of bankruptcy or insolvency of the Company, any right to require a proceeding first against the Company,
protest, notice and all demands whatsoever and covenant that this Guarantee will not be discharged except by complete performance of the obligations contained in the Notes and the Indenture. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(b)&nbsp;&nbsp;&nbsp;&nbsp;If any Holder or the Trustee is required by any court or otherwise to return to the Company, the Guarantors or any
custodian, trustee, liquidator or other similar official acting in relation to either the Company or the Guarantors, any amount paid either to the Trustee or such Holder, this Guarantee, to the extent theretofore discharged, shall be reinstated in
full force and effect. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(c)&nbsp;&nbsp;&nbsp;&nbsp;Each Guarantor agrees that it shall not be entitled to any right of subrogation in
relation to the Holders in respect of any obligations guaranteed hereby until payment in full of all obligations under the Notes guaranteed hereby. Each Guarantor further agrees that, as between the Guarantors, on the one hand, and the Holders and
the Trustee, on the other hand, (1)&nbsp;the maturity of the obligations guaranteed hereby may be accelerated as provided in Article V of the First Supplemental Indenture for the purposes of this Guarantee, notwithstanding any stay, injunction or
other prohibition preventing such acceleration in respect of the obligations guaranteed hereby, and (2)&nbsp;in the event of any declaration of acceleration of such obligations as provided in Article V of the First Supplemental Indenture, such
obligations (whether or not due and payable) will forthwith become due and payable by the Guarantors for purposes of this Guarantee. The Guarantors will have the right to seek contribution from any other Guarantor, or the Company, as the case may
be, so long as the exercise of such right does not impair the rights of the Holders under this Guarantee. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.02.&nbsp;&nbsp;&nbsp;&nbsp;<U>Limitation on Guarantor Liability</U>. Each Guarantor, and by its acceptance of the Notes, each
Holder, hereby confirms that it is the intention of all such parties that the Guarantee of such Guarantor of the Notes not constitute a fraudulent transfer, fraudulent conveyance or </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">3 </P>


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fraudulent obligation for purposes of Bankruptcy Law, the Uniform Fraudulent Conveyance Act, the Uniform Fraudulent Transfer Act or any similar federal or state law to the extent applicable to
any Guarantee of the Notes. To effectuate the foregoing intention, the Trustee, the Holders and the Guarantors hereby irrevocably agree that the obligations of such Guarantor shall be limited to the maximum amount that shall, after giving effect to
such maximum amount and all other contingent and fixed liabilities of such Guarantor that are relevant under such laws, and after giving effect to any collections from, rights to receive contributions from or payments made by or on behalf of any
other Guarantor in respect of the obligations of such other Guarantor under this Article II that are relevant under such laws, result in the obligations of such Guarantor under its Guarantee of the Notes not constituting a fraudulent transfer,
fraudulent conveyance or fraudulent obligation. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.03.&nbsp;&nbsp;&nbsp;&nbsp;<U>Execution and Delivery of Guarantees</U>.
</P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(a)&nbsp;&nbsp;&nbsp;&nbsp;To evidence its Guarantee as set forth in Section&nbsp;2.01 hereof, each Guarantor hereby agrees that this
Third Supplemental Indenture shall be executed on behalf of such Guarantor by one of its authorized officers or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">attorneys-in-fact.</FONT></FONT> </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(b)&nbsp;&nbsp;&nbsp;&nbsp;Each Guarantor hereby agrees that its Guarantee set forth in Section&nbsp;2.01 hereof shall remain in full force
and effect notwithstanding the absence of the endorsement of any notation of such Guarantee. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.04.&nbsp;&nbsp;&nbsp;&nbsp;<U>Contribution</U>. Each Guarantor that makes a payment or distribution under its Guarantee of the
Notes shall be entitled to contribution from any other Guarantor or the Company, as the case may be. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.05.&nbsp;&nbsp;&nbsp;&nbsp;<U>Releases</U>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(a)&nbsp;&nbsp;&nbsp;&nbsp;The Guarantee of the Notes by a Guarantor will be automatically and unconditionally released, and any Person
acquiring assets (including by way of merger or consolidation) or Capital Stock of a Guarantor shall not be required to assume the obligations of any such Guarantor: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(1)&nbsp;&nbsp;&nbsp;&nbsp;in connection with any sale, exchange, transfer, conveyance or other disposition of (whether by
merger, consolidation or the sale of) a majority of the Capital Stock of such Guarantor (or such lesser portion as is sufficient for such Guarantor to cease to be a Subsidiary of the Company) or the sale of all or substantially all the assets of
such Guarantor, to or with and into a Person which is not the Company or another Subsidiary of the Company; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(2)&nbsp;&nbsp;&nbsp;&nbsp;if any Guarantor is dissolved or otherwise no longer obligated to provide a Guarantee of the Notes
pursuant to the Indenture; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(3)&nbsp;&nbsp;&nbsp;&nbsp;if such Guarantor&#146;s guarantee of any obligations under any Debt
Facility of the Company (including the Credit Agreement) with an aggregate principal or committed amount of $250&nbsp;million or more is fully and unconditionally released, except that such Guarantor shall subsequently be required to become a
Guarantor by executing a supplemental indenture and providing the Trustee with an Officer&#146;s Certificate and Opinion of Counsel as required by the Indenture at such time as it guarantees any obligations under any Debt Facility of the Company
(including the Credit Agreement) with an aggregate principal or committed amount of $250&nbsp;million or more; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(4)&nbsp;&nbsp;&nbsp;&nbsp;upon the Company&#146;s exercise of its legal defeasance option or covenant defeasance option as
described in Section&nbsp;12.02 or Section&nbsp;12.03 of the First Supplemental Indenture or if the Company&#146;s obligations under the Indenture and the Notes are discharged in accordance with Section&nbsp;12.01 of the First Supplemental
Indenture. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">4 </P>


<p Style='page-break-before:always'>
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 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(b)&nbsp;&nbsp;&nbsp;&nbsp;The Trustee shall execute any documents reasonably requested by either
the Company or a Guarantor in order to evidence the release of such Guarantor from its obligations under its Guarantee under this Article II, subject to the Trustee&#146;s receipt of an Opinion of Counsel and Officer&#146;s Certificates stating that
all conditions precedent to such release have been met. </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE III </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MISCELLANEOUS PROVISIONS </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.01.&nbsp;&nbsp;&nbsp;&nbsp;<U>Ratification of Indenture</U>. Except as expressly modified or amended hereby, the Indenture
continues in full force and effect and is in all respects confirmed, ratified and preserved and the provisions thereof shall be applicable to the Notes and this Third Supplemental Indenture. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.02.&nbsp;&nbsp;&nbsp;&nbsp;<U>Provisions Binding on Company</U><U>&#146;</U><U>s Successors</U>. All the covenants,
stipulations, promises and agreements of the Company contained in this Third Supplemental Indenture shall bind its successors and assigns whether so expressed or not. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.03.&nbsp;&nbsp;&nbsp;&nbsp;<U>Official Acts by Successor Corporation</U>. Any act or proceeding by any provision of this Third
Supplemental Indenture authorized or required to be done or performed by any board, committee or officer of the Company shall and may be done and performed with like force and effect by the like board, committee or officer of any corporation or
entity that shall at the time be the lawful sole successor of the Company. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.04.&nbsp;&nbsp;&nbsp;&nbsp;<U>Addresses for
Notices, Etc</U>. Any notice or demand which by any provision of this Third Supplemental Indenture is required or permitted to be given or served by the Trustee or by the Noteholders on the Company or the Guarantors shall be deemed to have been
sufficiently given or made, for all purposes if given or served by being deposited postage prepaid by registered or certified mail in a post office letter box addressed (until another address is filed by the Company with the Trustee) to the Company
at 1301 Concord Terrace, Sunrise, Florida 33323, Attention: General Counsel. Any notice, direction, request or demand hereunder to or upon the Trustee shall be deemed to have been sufficiently given or made, for all purposes, if given or served by
being deposited postage prepaid by registered or certified mail in a post office letter box addressed to U.S. Bank National Association at 1349 W. Peachtree Street, Suite 1050, Atlanta, Georgia 30309, Attention: George Hogan. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Trustee, by notice to the Company, may designate additional or different addresses for subsequent notices or communications. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Any notice or communication mailed to a Noteholder shall be mailed to him by first class mail, postage prepaid, at his address as it appears
on the Security Register and shall be sufficiently given to him if so mailed within the time prescribed. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Failure to mail a notice or
communication to a Noteholder or any defect in it shall not affect its sufficiency with respect to other Noteholders. If a notice or communication is mailed in the manner provided above, it is duly given, whether or not the addressee receives it.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.05.&nbsp;&nbsp;&nbsp;&nbsp;<U>Governing Law</U>. THIS THIRD SUPPLEMENTAL INDENTURE SHALL BE GOVERNED BY AND CONSTRUED IN
ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK WITHOUT REGARD TO CONFLICT OF LAWS PRINCIPLES OF SUCH STATE OTHER THAN NEW YORK GENERAL OBLIGATIONS LAW SECTION <FONT STYLE="white-space:nowrap">5-1401.</FONT> THIS THIRD SUPPLEMENTAL INDENTURE IS
SUBJECT TO THE PROVISIONS OF THE TIA THAT ARE REQUIRED TO BE A PART OF THIS THIRD SUPPLEMENTAL INDENTURE AND SHALL, TO THE EXTENT APPLICABLE, BE GOVERNED BY SUCH PROVISIONS. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">5 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">


 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.06.&nbsp;&nbsp;&nbsp;&nbsp;<U>Benefits of Indenture</U>. Nothing in the Indenture
or in the Notes, expressed or implied, shall give to any person, other than the parties hereto, any Paying Agent, any authenticating agent, any Security Registrar and their successors hereunder, the Noteholders, any benefit or any legal or equitable
right, remedy or claim under the Indenture. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.07.&nbsp;&nbsp;&nbsp;&nbsp;<U>Headings, Etc</U>. The titles and headings of
the articles and sections of this Third Supplemental Indenture have been inserted for convenience of reference only, are not to be considered a part hereof, and shall in no way modify or restrict any of the terms or provisions hereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.08.&nbsp;&nbsp;&nbsp;&nbsp;<U>Counterparts</U>. This Third Supplemental Indenture may be executed and delivered in any number
of counterparts, each of which when so executed and delivered shall be deemed to be an original, and all such counterparts shall together constitute but one and the same instrument. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.09.&nbsp;&nbsp;&nbsp;&nbsp;<U>Trustee</U>. The Trustee makes no representations as to the validity or sufficiency of this Third
Supplemental Indenture. The statements and recitals herein are deemed to be those of the Company and not of the Trustee. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.10.&nbsp;&nbsp;&nbsp;&nbsp;<U>Further Instruments and Acts</U>. Upon request of the Trustee, the Company will execute and
deliver such further instruments and do such further acts as may be reasonably necessary or proper to carry out more effectively the purposes of this Third Supplemental Indenture. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.11.&nbsp;&nbsp;&nbsp;&nbsp;<U>Waiver of Jury Trial</U>. EACH OF THE COMPANY, THE GUARANTORS AND THE TRUSTEE HEREBY IRREVOCABLY
WAIVES, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, ANY AND ALL RIGHT TO TRIAL BY JURY IN ANY LEGAL PROCEEDING ARISING OUT OF OR RELATING TO THE INDENTURE, THE NOTES OR THE TRANSACTION CONTEMPLATED HEREBY. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><I>[Remainder of page left intentionally blank] </I></B></P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">6 </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">


 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>IN WITNESS WHEREOF</B>, the parties hereto have caused this Third Supplemental Indenture to be duly executed
by their respective officers hereunto duly authorized, all as of the day and year first above written. </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


<TR>
<TD WIDTH="45%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="4%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="4%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="44%"></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">COMPANY:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>MEDNAX, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">By:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"> <P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Vivian Lopez-Blanco</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Name:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Vivian Lopez-Blanco</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Title:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Chief Financial Officer and Treasurer</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">TRUSTEE:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>U.S. BANK NATIONAL ASSOCIATION</B>,<B></B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">By:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"> <P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ George Hogan</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Name:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">George Hogan</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Title:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Vice-President</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">GUARANTORS:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>JEFFERSON RADIOLOGY, P.C.</B>, a Connecticut professional corporation</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>MEDNAX RADIOLOGY OF TEXAS, INC.</B>, a Texas corporation</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>RADIOLOGY ASSOCIATES OF SOUTH FLORIDA, LLC</B>,<B></B> a Florida limited liability company</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>THE SURGICAL GROUP OF MIAMI, LLC</B>, a Florida limited liability company</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>SYNTHESIS HEALTHCARE MANAGEMENT, LLC</B>, a Florida limited liability company</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="6"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><B>SYNERGY RADIOLOGY ASSOCIATES, PLLC</B>, a Texas professional limited liability company</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">By:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"> <P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;/s/ Dominic J. Andreano</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5">Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">Attorney-in-Fact</FONT></FONT> of each of the foregoing</TD></TR>
</TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">[SIGNATURE PAGE TO
SUPPLEMENTAL INDENTURE] </P>


<p Style='page-break-before:always'>
<HR  SIZE="3" style="COLOR:#999999" WIDTH="100%" ALIGN="CENTER">


 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><U>Schedule A </U></B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Guarantors </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">1.</TD>
<TD ALIGN="left" VALIGN="top">Jefferson Radiology, P.C. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">2.</TD>
<TD ALIGN="left" VALIGN="top">Mednax Radiology of Texas, Inc. </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">3.</TD>
<TD ALIGN="left" VALIGN="top">Radiology Associates of South Florida, LLC </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">4.</TD>
<TD ALIGN="left" VALIGN="top">The Surgical Group of Miami, LLC </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">5.</TD>
<TD ALIGN="left" VALIGN="top">Synthesis Healthcare Management, LLC </TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">6.</TD>
<TD ALIGN="left" VALIGN="top">Synergy Radiology Associates, PLLC </TD></TR></TABLE>
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<DOCUMENT>
<TYPE>EX-10.28
<SEQUENCE>4
<FILENAME>d463027dex1028.htm
<DESCRIPTION>EX-10.28
<TEXT>
<HTML><HEAD>
<TITLE>EX-10.28</TITLE>
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 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Exhibit 10.28 </B></FONT></P> <P STYLE="margin-top:24px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>EMPLOYMENT AGREEMENT </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>THIS EMPLOYMENT AGREEMENT</B> (this
&#147;Agreement&#148;) is made and entered into by and between <B>MEDNAX SERVICES, INC.</B>, a Florida corporation (&#147;Employer&#148;) and <B>VIVIAN LOPEZ-BLANCO</B> (&#147;Employee&#148;) effective as the Effective Date. </FONT></P>
<P STYLE="margin-top:24px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>RECITALS </B></FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>WHEREAS</B>,<B> </B>Employer is presently engaged in &#147;Employer&#146;s Business&#148; as defined on Exhibit A hereto; and
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>WHEREAS</B>,&nbsp;&nbsp;&nbsp;&nbsp;Employer and Employee previously entered in an Employment Agreement dated May&nbsp;27,
2010, as amended (the &#147;Prior Employment Agreement&#148;), which will be allowed to expire by its terms on May&nbsp;26, 2018 and will not be renewed; and </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>WHEREAS</B>,&nbsp;&nbsp;&nbsp;&nbsp;Employer desires to employ Employee and benefit from Employee&#146;s contributions to Employer; and </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>WHEREAS</B>, in order to induce Employer to enter into this Agreement on the terms and conditions set forth herein (including an
increase in compensation over what was provided under the Prior Employment Agreement), and disclose its trade secrets and confidential information in connection with Employee&#146;s employment by Employer and award from time to time equity based
compensation, Employee hereby agrees to be bound by the terms of this Agreement, including the arbitration, <FONT STYLE="white-space:nowrap">non-competition</FONT> and related restrictive covenants set forth herein. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>NOW, THEREFORE</B>, in consideration of the premises and mutual covenants set forth herein, the parties agree as follows: </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>1.&nbsp;&nbsp;&nbsp;&nbsp;Employment. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">1.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Employment and Term</I>. Employer hereby agrees to employ Employee and Employee hereby agrees to serve Employer on the terms and conditions set forth herein for an
&#147;Initial Term&#148; commencing February&nbsp;12, 2018<B> </B>(the &#147;Effective Date&#148;) and continuing for a period of three (3)&nbsp;years, unless sooner terminated as hereinafter set forth. Thereafter, the employment of Employee
hereunder shall automatically renew for successive one (1)&nbsp;year periods until terminated in accordance herewith. The Initial Term and any automatic renewals shall be referred to as the &#147;Employment Period.&#148; </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">1.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>Duties of Employee</I>. During the Employment Period, Employee shall serve as Chief Financial Officer and
Treasurer of Employer and MEDNAX, Inc., a Florida corporation and parent corporation of the Employer (&#147;Mednax&#148;) and perform such duties as are customary to the position Employee holds or as may be assigned to Employee from time to time by
Mednax&#146;s Chief Executive Officer or President (&#147;Employee&#146;s Supervisor&#148;); <I>provided, </I>that such duties as assigned shall be customary to Employee&#146;s role as an executive officer of Employer and Mednax. Employee&#146;s
employment shall be full-time and as such Employee agrees to devote substantially all of </FONT></P>

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Employee&#146;s attention and professional time to the business and affairs of Employer and Mednax. Employee shall perform Employee&#146;s duties honestly, diligently, competently, in good faith
and in the best interest of Employer and Mednax. Employee will devote best efforts to the promotion of the goodwill of Employer and Mednax and of their employees and affiliates. During the Employment Term, Employer shall promote the proficiency of
Employee by, among other things, providing Employee with Confidential Information, specialized professional development programs, and information regarding the organization, administration and operation of Employer. During the Employment Period,
Employee agrees that Employee will not, without the prior written consent of Employer (which consent shall not be unreasonably withheld), serve as a director on a corporate board of directors or in any other similar capacity for any institution
other than Employer. During the Employment Period, it shall not be a violation of this Agreement to (i)&nbsp;serve on civic or charitable boards or committees, or (ii)&nbsp;deliver lectures, fulfill speaking engagements or teach at educational
institutions, so long as such activities have been approved by Employer&#146;s General Counsel and do not interfere with the performance of Employee&#146;s responsibilities as an employee of Employer in accordance with this Agreement, including the
restrictions of Section&nbsp;8 hereof. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">1.3.&nbsp;&nbsp;&nbsp;&nbsp;<I>Place of Performance</I>. Employee shall be based at
Employer&#146;s offices located in Sunrise, Florida, except for required travel relating to Employer&#146;s Business. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>2.&nbsp;&nbsp;&nbsp;&nbsp;Base Salary and Performance Bonus. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Base Salary</I>. Employee shall be paid an annual base salary as determined by the Compensation Committee
(&#147;Compensation Committee&#148;) of the MEDNAX, Inc. Board of Directors (the &#147;Board&#148;) from time to time (the &#147;Base Salary&#148;), payable in installments consistent with Employer&#146;s customary payroll schedule and subject to
applicable withholding for taxes and other Employee directed withholdings. The Compensation Committee shall review the amount of Employee&#146;s Base Salary on an annual basis no later than ninety (90)&nbsp;days after the beginning of
Employer&#146;s fiscal year. Any change to Employee&#146;s Base Salary that is approved by the Compensation Committee shall become Employee&#146;s new Base Salary for purposes of this Agreement. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.2.&nbsp;&nbsp;&nbsp;&nbsp;Performance Bonus. Employee shall be eligible for an annual bonus in accordance with the incentive programs
approved from time to time by the Compensation Committee, which programs shall contemplate a target bonus payment of at least the amount set forth on Exhibit B (the &#147;Performance Bonus&#148;) based upon the fulfillment of reasonable performance
objectives set by the Compensation Committee. Except in the situations described in Sections 5.2, 5.3, 5.4, 5.5 and 5.7, the Performance Bonus shall only be payable to Employee if Employee is employed with Employer as of the date that the
Performance Bonus is paid by Employer. Each Performance Bonus shall be paid in the calendar year immediately following the calendar year in which it is earned, as soon as practicable after the audited financial statements for Employer for the year
for which the bonus is earned have been released; provided, however, that if calculation of Employee&#146;s Performance Bonus is not administratively practicable due to events beyond the control of Employer, then Employer may delay payment of the
Performance Bonus provided that the payment is made during the first taxable year of Employee in which the calculation of the amount of the payment is administratively practicable. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">2 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>3.&nbsp;&nbsp;&nbsp;&nbsp;Benefits. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Expense Reimbursement</I>. Employer shall promptly reimburse Employee for all <FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-pocket</FONT></FONT> expenses reasonably incurred by Employee during the Employment Period on behalf of or in connection with Employer&#146;s Business pursuant to the reimbursement
standards and guidelines of Employer in effect from time to time, including reimbursement for appropriate professional organizations. Employee shall account for such expenses and submit reasonable supporting documentation to Employer in accordance
with Employer&#146;s policies in effect from time to time. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.2&nbsp;&nbsp;&nbsp;&nbsp;<I>Employee Benefits</I>. During the
Employment Period, Employee shall be entitled to participate in such health, welfare, disability, retirement savings and other fringe benefit plans and programs (subject to the terms and conditions of such plans and programs) as may be provided from
time to time to employees of Employer and to the extent that such plans and programs are applicable to other similarly situated employees of Employer. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">3.3.&nbsp;&nbsp;&nbsp;&nbsp;<I>Leave Time</I>. During the Employment Period, Employee shall be entitled to paid vacation and leave days each calendar year in accordance with the leave policies established
by Employer from time to time, but in no event less than thirty-eight (38)&nbsp;days per year. Any leave time not used during each fiscal year of Employer may be carried over into the next year to the extent permitted by Employer policy. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.4&nbsp;&nbsp;&nbsp;&nbsp;<I>Equity Plans. </I>During the Employment Period, Employee shall be eligible to participate in Mednax&#146;s
Amended and Restated 2008 Incentive Compensation Plan, as amended, or any other similar plan adopted by Mednax (each an &#147;Equity Plan&#148;) that provides for the issuance of stock options, stock appreciation rights, restricted stock, deferred
stock, bonus stock, awards payable in stock or any other stock based award (each an &#147;Equity Award&#148;). Employee&#146;s stock-based award each year shall be determined by the Compensation Committee based on Employee&#146;s performance and
Employer&#146;s performance during the immediately preceding year and shall be at least consistent with the Compensation Committee&#146;s determination of Employee&#146;s stock-based award in prior years. Every Equity Award made to Employee shall be
subject to the terms and conditions of this Agreement, the applicable award agreement and the terms of the Equity Plan. Employee shall also be eligible to participate in Mednax&#146;s <FONT STYLE="white-space:nowrap">non-qualified</FONT> employee
stock purchase plan and any successor plan. Employee acknowledges Employee&#146;s participation in the Equity Plan pursuant to this Section&nbsp;3 is sufficient consideration for Employee to enter into this Agreement, including the restrictive
covenants set forth in Section&nbsp;8 below<I>. </I> </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>4.&nbsp;&nbsp;&nbsp;&nbsp;Termination. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination for Cause</I>. Employer may terminate Employee&#146;s employment under this Agreement for
Cause. As used in this Agreement, the term &#147;Cause&#148; shall mean: </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a)&nbsp;&nbsp;&nbsp;&nbsp;Any act or
omission of Employee, which is materially contrary to the business interests, reputation or goodwill of Employer; </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">3 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(b)&nbsp;&nbsp;&nbsp;&nbsp;A material breach by Employee of Employee&#146;s
obligations under this Agreement, which breach is not promptly remedied upon written notice from Employer; </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(c)&nbsp;&nbsp;&nbsp;&nbsp;Employee&#146;s refusal to perform Employee&#146;s duties as assigned pursuant to this
Agreement other than a refusal which is remedied by Employee promptly after receipt of written notice thereof by Employer; or </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(d)&nbsp;&nbsp;&nbsp;&nbsp;Employee&#146;s failure or refusal to comply with a reasonable policy, standard or regulation of Employer in any material respect, including but not limited to Employer&#146;s
sexual harassment, other unlawful harassment, workplace discrimination or substance abuse policies. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">The termination date for a termination of
Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.1 shall be the date specified by Employer in a written notice to Employee of finding of Cause, which may not be retroactive. Upon any termination of Employee&#146;s
employment under this Agreement pursuant to this Section&nbsp;4.1, Employee shall be entitled to the compensation specified in Section&nbsp;5.1 hereof. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">4.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>Disability</I>. Employer may terminate Employee&#146;s employment under this Agreement upon the Disability (as defined below) of Employee. Subject to the requirements of
applicable law, Employee shall be deemed to have a &#147;Disability&#148; for purposes of this Agreement in the event of (i)&nbsp;Employee&#146;s inability to perform Employee&#146;s duties hereunder, with or without a reasonable accommodation, as a
result of physical or mental illness or injury, and (ii)&nbsp;a determination by an independent qualified physician selected by Employer and acceptable to Employee (which acceptance shall not be unreasonably withheld) that Employee is currently
unable to perform such duties and in all reasonable likelihood such inability will continue for a period in excess of an additional ninety (90)&nbsp;or more days in any one hundred twenty (120)&nbsp;day period. The termination date for a termination
of this Agreement pursuant to this Section&nbsp;4.2 shall be the date specified by Employer in a notice to Employee, which date shall not be retroactive. Upon any termination of this Agreement pursuant to this Section&nbsp;4.2, Employee shall be
entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.2 hereof. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.3.&nbsp;&nbsp;&nbsp;&nbsp;<I>Death</I>. Employee&#146;s employment under this<B> </B>Agreement shall terminate automatically upon the
death of Employee, without any requirement of notice by Employer to Employee&#146;s estate. The date of Employee&#146;s death shall be the termination date for a termination of Employee&#146;s employment under this Agreement pursuant to this
Section&nbsp;4.3. Upon any termination of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.3, Employee shall be entitled to the compensation specified in Section&nbsp;5.3 hereof. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.4.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employer Without Cause</I>. Employer may terminate Employee&#146;s employment without cause
by giving Employee written notice of such termination. The termination date shall be the date specified by Employer in such notice, which may be up to ninety (90)&nbsp;days from the date of such notice. Upon any termination of Employee&#146;s
employment under this Agreement pursuant to this Section&nbsp;4.4, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.4 hereof. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">4 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.5.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employee Due to Poor Health</I>. Employee may
terminate Employee&#146;s employment under this Agreement upon written notice to Employer if Employee&#146;s health should become impaired to any extent that makes the continued performance of Employee&#146;s duties under this Agreement hazardous to
Employee&#146;s physical or mental health or Employee&#146;s life (regardless of whether such condition would be deemed a Disability under any other Section of this Agreement), <I>provided </I>that Employee shall have furnished Employer with a
written statement from a qualified doctor to that effect, and <I>provided further</I> that, at Employer&#146;s written request and expense, Employee shall submit to a medical examination by an independent qualified physician selected by Employer and
acceptable to Employee (which acceptance shall not be unreasonably withheld), which doctor shall substantially concur with the conclusions of Employee&#146;s doctor. The termination date shall be the date specified in Employee&#146;s notice to
Employer, which date may not be earlier than thirty (30)&nbsp;days nor later than ninety (90)&nbsp;days from Employer&#146;s receipt of such notice. Upon any termination of Employee&#146;s employment under this Agreement pursuant to this
Section&nbsp;4.5, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.5 hereof. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">4.6.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employee</I>. Employee may terminate Employee&#146;s employment under this Agreement for any reason whatsoever upon not less than ninety (90)&nbsp;days prior
written notice to Employer. Upon receipt of such notice from Employee, Employer may, at its option, require Employee to terminate employment at any time in advance of the expiration of such ninety (90)&nbsp;day period. The termination date under
this Section&nbsp;4.6 shall be the date specified by Employer, but in no event more than ninety (90)&nbsp;days after Employer&#146;s receipt of notice from Employee as contemplated by this Section. Upon any termination of Employee&#146;s employment
under this Agreement pursuant to this Section&nbsp;4.6, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.6 hereof. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.7.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employee for Good Reason. </I>Employee may terminate Employee&#146;s employment hereunder
for Good Reason. For purposes of this Section, &#147;Good Reason&#148; shall mean: </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a)
&nbsp;&nbsp;&nbsp;&nbsp;a decrease in Employee&#146;s Base Salary; </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(b) &nbsp;&nbsp;&nbsp;&nbsp;a decrease in
the Performance Bonus potential utilized by Employer in determining a Performance Bonus for Employee; or </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(c)&nbsp;&nbsp;&nbsp;&nbsp;within a twenty-four (24)&nbsp;month period after a Change in Control (as defined below),
Employee is either (i)&nbsp;assigned any position, duties, responsibilities or compensation that is inconsistent with the position, duties, responsibilities or compensation of Employee prior to such Change in Control, (ii)&nbsp;required to report to
any person other than the President or Chief Executive Officer of Employer in place just prior to the Change in Control (unless Employee becomes Chief Executive Officer of Employer or its equivalent and reports directly to the Board, as defined
below), or (iii)&nbsp;required to perform services under this Agreement from another location more than twenty-five (25)&nbsp;miles from Employee&#146;s location prior to the Change in Control. For purposes of this Agreement, &#147;Change in
Control&#148; shall mean (i)&nbsp;the acquisition by a person or an entity or a group of persons and </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">5 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">
entities, directly or indirectly, of more than fifty (50%) percent of Mednax&#146;s common stock in a single transaction or a series of transactions (hereinafter referred to as a &#147;50% Change
in Control&#148;), (ii) a merger or other form of corporate reorganization of Mednax resulting in an actual or <I>de facto</I> 50% Change in Control, or (iii)&nbsp;the failure of Applicable Directors (defined below) to constitute a majority of the
Board during any two (2)&nbsp;consecutive year period after the date of this Agreement (the <FONT STYLE="white-space:nowrap">&#147;Two-Year</FONT> Period&#148;). &#147;Applicable Directors&#148; shall mean those individuals who are members of the
Board at the inception of a <FONT STYLE="white-space:nowrap">Two-Year</FONT> Period and any new director whose election to the Board or nomination for election to the Board was approved (prior to any vote thereon by the shareholders) by a vote of at
least <FONT STYLE="white-space:nowrap">two-thirds</FONT> (2/3) of the directors then still in office who either were directors at the beginning of the <FONT STYLE="white-space:nowrap">Two-Year</FONT> Period at issue or whose election or nomination
for election during such <FONT STYLE="white-space:nowrap">Two-Year</FONT> Period was previously approved as provided in this sentence; or </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(d)&nbsp;&nbsp;&nbsp;&nbsp;the assignment to Employee of any position inconsistent with the present position Employee holds, or material diminution in Employee&#146;s authority, excluding for this purpose
any isolated, insubstantial and inadvertent action not taken in bad faith and which is remedied by Employer promptly after receipt of written notice; or </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(e)&nbsp;&nbsp;&nbsp;&nbsp;the requirement by Employer that Employee be based in any office or location outside of the metropolitan area where Employer&#146;s present corporate offices are located (it
being understood that Employee may be presently based at another location), except for travel reasonably required in the performance of Employee&#146;s duties. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(f)&nbsp;&nbsp;&nbsp;&nbsp;any other action or inaction that constitutes a material breach of this Agreement by Employer. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2">If Employee desires to terminate Employee&#146;s employment under this Agreement pursuant to this Section, Employee must, within ninety (90)&nbsp;days after the occurrence of events giving rise to the
Good Reason, provide Employer with a written notice describing the Good Reason in reasonable detail. If Employer fails to cure the matter cited within thirty (30)&nbsp;days after the date of Employee&#146;s notice, then this Agreement shall
terminate as of the end of such thirty (30)&nbsp;day cure period, <I>provided, however, </I>that Employer may, at its option, require Employee to terminate employment at any time in advance of the expiration of such thirty (30)&nbsp;day cure period.
If Employee terminates Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.7, then Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.7 hereof.
</FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>5.&nbsp;&nbsp;&nbsp;&nbsp;Compensation and Benefits Upon Termination. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Cause</I>. If Employee&#146;s employment is terminated for Cause, Employer shall pay Employee&#146;s Base
Salary through the termination date specified in Section&nbsp;4.1 at the rate in effect at the termination date. Upon payment of such amounts, plus any amounts as may be due under Section&nbsp;5.8 below, Employer shall have no further obligation to
Employee under this Agreement. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">6 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>Disability</I>. In the event of Employee&#146;s Disability,
Employee shall continue to receive Employee&#146;s Base Salary for the first ninety (90)&nbsp;days of Disability. Thereafter, payments, if any, shall be administered pursuant to Employer&#146;s sponsored long-term disability policy. If
Employee&#146;s employment is terminated pursuant to Section&nbsp;4.2 in connection with Employee&#146;s Disability, Employee shall receive fifty percent (50%) of Employee&#146;s annual Base Salary at the rate in effect at the termination date,
payable in six (6)&nbsp;equal monthly installments after the termination date, plus a bonus calculated in accordance with Section&nbsp;5.11 and any amounts as may be due under Section&nbsp;5.8 and 5.9. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.3.&nbsp;&nbsp;&nbsp;&nbsp;<I>Death</I>. Upon Employee&#146;s death during the Employment Period, Employer shall pay to the person or
entity designated by Employee in a notice filed with Employer or, if no person is designated, to Employee&#146;s estate any unpaid amounts of Base Salary to the date of Employee&#146;s death, plus any amounts as may be due under Sections 5.8 and
5.11 below. Any payments Employee&#146;s spouse, beneficiaries or estate may be entitled to receive pursuant to any pension plan, employee welfare benefit plan, life insurance policy, or similar plan or policy then maintained by Employer shall be
determined and paid in accordance with the written instruments governing the respective plans and policies. In the event of Employee&#146;s death during the Employment Period, Employer shall notify Employee&#146;s designee or estate of the Equity
Awards held by Employee and the procedures pursuant to which all vested stock options may be exercised and other Equity Awards may be realized under the terms applicable to such awards. Upon full payment of all amounts required to be paid under this
Section&nbsp;5.3, Employer shall have no further obligation under this Agreement. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%;padding-bottom:0px; "><FONT STYLE="font-family:Times New Roman" SIZE="2">5.4.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employer Without Cause</I>. If Employer terminates Employee&#146;s
employment in accordance with Section&nbsp;4.4, then (i)&nbsp;Employer shall pay Employee&#146;s Base Salary through the termination date specified in Section&nbsp;4.4 at the rate in effect at such termination date, plus any amount due under
Section&nbsp;5.8 hereof; (ii)&nbsp;within thirty (30)&nbsp;days, pay Employee a bonus calculated in accordance with Section&nbsp;5.11 hereof; (iii)&nbsp;Employer shall continue to pay Employee&#146;s monthly Base Salary for a period of eighteen
(18)&nbsp;months after the termination date; (iv)&nbsp;within thirty (30)&nbsp;days of the first (1</FONT><FONT STYLE="font-family:Times New Roman" SIZE="1"><SUP STYLE="vertical-align:baseline; position:relative; bottom:.8ex">st</SUP></FONT><FONT
STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;anniversary of the termination date, pay Employee an amount equal to Employee&#146;s Average Annual Performance Bonus (as defined below); and (v)&nbsp;if applicable, Employee shall vest into the
Accelerated Awards (as defined below) as set forth in Section&nbsp;5.14 hereof. For purposes of this Agreement, &#147;Average Annual Performance Bonus&#148; shall be equal to the average of the percentage of the Performance Bonus target achieved by
Employee for the three (3)&nbsp;full calendar years prior to the termination date, and calculated based on Employee&#146;s Base Salary and target Performance Bonus in Employee&#146;s current position. <I>For illustration purposes, if Employee earned
40%, 100% and 70% of Employee&#146;s target Performance Bonus in each of the three full calendar years prior to termination, and Employee&#146;s current target Performance Bonus was 100% of Base Salary, and Base Salary was $450,000.00, then
Employee&#146;s Average Annual Performance Bonus would equal $315,000.00. ((40%+ 100% + 70%) / 3 x 100% x $450,000.00 = $315,000.00). </I>Upon payment of the amounts specified under Sections 5.4 and 5.11, Employer shall have no further obligation
under this Agreement. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.5.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employee Due to Poor Health. </I>If Employee terminates
Employee&#146;s employment under this Agreement pursuant to Section&nbsp;4.5 hereof, Employer shall pay to Employee any unpaid amounts of Base Salary to the termination date specified in Section&nbsp;4.5, plus any disability payments otherwise
payable by or pursuant to plans provided by Employer, plus any amounts as may be due under Section&nbsp;5.8 and 5.11 below. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">7 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.6.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employee</I>. If Employee&#146;s employment
under this Agreement terminates pursuant to Section&nbsp;4.6 hereof, Employer shall pay to Employee any unpaid amounts of Base Salary to the termination date specified in Section&nbsp;4.6, plus any amounts as may be due under Section&nbsp;5.8 below.
In the event that the termination date specified by Employer is less than ninety (90)&nbsp;days after the date of Employer&#146;s receipt of notice as contemplated by Section&nbsp;4.6, then Employer shall continue Employee&#146;s Base Salary for a
period of days equal to ninety (90)&nbsp;minus the number of days from Employee&#146;s notice to the termination date. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.7.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination for Good Reason.</I><B> </B>If Employee&#146;s employment under this Agreement is terminated
pursuant to Sections&nbsp;4.7(a), (b), (d), (e), or (f), then Employer shall (i)&nbsp;pay Employee&#146;s Base Salary through the termination date specified in Section&nbsp;4.7 at the rate in effect at such termination date, (ii)&nbsp;pay any
amounts as may be due under Section&nbsp;5.8 and 5.11, and (iii)&nbsp;continue to pay Employee&#146;s Base Salary for a period of twelve (12)&nbsp;months after the termination date. If this Agreement is terminated pursuant to Section&nbsp;4.7(c),
then Employer shall (i)&nbsp;pay Employee&#146;s Base Salary through the termination date specified in Section&nbsp;4.7 at the rate in effect at such termination date, (ii)&nbsp;pay any amounts as may be due under Sections 5.8 and 5.11, and
(iii)&nbsp;continue to pay Employee&#146;s Base Salary for a period of eighteen (18)&nbsp;months after the termination date. <B></B>In addition, notwithstanding any contrary provision in any Equity Plan, in the event of Employee&#146;s termination
pursuant to Section&nbsp;4.7(c), any unvested Equity Awards held by Employee on the termination date shall fully vest and in the case of stock options, become immediately exercisable. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.8.&nbsp;&nbsp;&nbsp;&nbsp;<I>Expense Reimbursement. </I>Employee shall be entitled to reimbursement for reasonable business expenses
incurred prior to the termination date, subject, however to the provisions of Section&nbsp;3.1. Such reimbursement shall be made at the times and in accordance with Employer&#146;s normal procedures for reimbursements. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.9.&nbsp;&nbsp;&nbsp;&nbsp;<I>Continuation of Benefit Plans</I>. Employee shall be entitled to continuation of health, medical,
hospitalization and other similar health insurance programs on the same basis as regular, full-time employees of Employer and their eligible dependents during the period that Employee is receiving Base Salary payments under Section&nbsp;5 of this
Agreement and, in all cases, as provided by any applicable law. Following such period of continued benefit plan coverage, Employee and each of her eligible dependents shall be entitled to elect for continuation of coverage provided pursuant to
Section&nbsp;601 et. seq. of the Employee Retirement Income Security Act of 1974, 29 USC &#167;1101 (&#147;COBRA&#148;). </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.10&nbsp;&nbsp;&nbsp;&nbsp;<I>Period for Exercising Stock Options After Termination. </I>Except as to incentive stock options granted in
accordance with Section&nbsp;422 of the Internal Revenue Code, after termination of Employee&#146;s employment under this Agreement for any reason other than pursuant to Section&nbsp;4.1, Employee shall be allowed a period of one hundred eighty
(180)&nbsp;days during which to exercise any vested options to purchase Mednax&#146;s common stock or vested stock appreciation rights and realize any other vested Equity Awards that may be granted or made under any Equity Plan; provided, however,
that in no event shall the period during which Employee may exercise any vested stock option or vested stock appreciation right be extended pursuant to this Section&nbsp;5.10 to a date that is later than the earlier of (i)&nbsp;the latest date upon
which the stock right could have expired by its </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">8 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px;padding-bottom:0px; "><FONT STYLE="font-family:Times New Roman" SIZE="2">
original terms under any circumstances or (ii)&nbsp;the tenth
(10</FONT><FONT STYLE="font-family:Times New Roman" SIZE="1"><SUP STYLE="vertical-align:baseline; position:relative; bottom:.8ex">th</SUP></FONT><FONT STYLE="font-family:Times New Roman" SIZE="2">) anniversary of the original date of grant of the
stock right. In all other respects, the terms of the applicable Equity Plan shall control the terms and conditions of any Equity Awards. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">5.11.&nbsp;&nbsp;&nbsp;&nbsp;<I>Performance Bonus. </I>In the situations described in Sections 5.2, 5.3, 5.4, 5.5 and 5.7, upon termination of this Agreement, Employee<B> </B>will be paid, solely in
consideration of services rendered by Employee prior to termination, a bonus with respect to Employer&#146;s fiscal year in which the termination date occurs, equal to the Performance Bonus, if any, that would have been payable to Employee, based on
Employee and Employer meeting certain goals and objectives, for the fiscal year if Employee&#146;s employment had not been terminated, multiplied by the number of days in the fiscal year prior to and including the date of termination and divided by
three hundred sixty five (365). The amount of the Post-Termination Performance Bonus paid in the situations described in Sections 5.2, 5.3, 5.4 5.5 and 5.7 shall be determined in good faith by Employer in its sole discretion at the time that
Employer distributes bonuses to similarly situated employees. Any amount payable under this Section&nbsp;5.11 shall be paid to Employee when Employer pays performance bonuses to its eligible employees, which shall be in the calendar year following
the termination date of this Agreement. In addition, in the situations described in Section&nbsp;5.7, Employee will be paid, solely in consideration of services rendered by Employee prior to termination, an additional bonus with respect to
Employer&#146;s fiscal year in which the termination date occurs, equal to the greater of Employee&#146;s Average Annual Performance Bonus (as defined in Section&nbsp;5.4) or Employee&#146;s bonus for the year immediately preceding Employee&#146;s
termination. Such additional bonus shall be payable to Employee within ninety (90)&nbsp;days of Employee&#146;s termination date pursuant to Section&nbsp;4.7. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">5.12.&nbsp;&nbsp;&nbsp;&nbsp;<I>Section</I> <I>409A Compliance</I>. </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a)&nbsp;&nbsp;&nbsp;&nbsp;General.<B> </B>It is the intention of both Employer and Employee that the benefits and rights
to which Employee could be entitled in connection with termination of employment comply with Section&nbsp;409A of the Code and the Treasury Regulations and other guidance promulgated or issued thereunder (&#147;Section&nbsp;409A&#148;), and the
provisions of this Agreement shall be construed in a manner consistent with that intention. If Employee or Employer believes, at any time, that any such benefit or right does not so comply, it shall promptly advise the other and shall negotiate
reasonably and in good faith to amend the terms of such benefits and rights such that they comply with Section&nbsp;409A of the Code (with the most limited possible economic effect on Employee and on Employer). </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(b)&nbsp;&nbsp;&nbsp;&nbsp;Distributions on Account of Separation from Service.<B> </B>If and to the extent required to
comply with Section&nbsp;409A, no payment or benefit required to be paid under this Agreement on account of termination of Employee&#146;s employment shall be made unless and until Employee incurs a &#147;separation from service&#148;, within the
meaning of Section&nbsp;409A. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(c)&nbsp;&nbsp;&nbsp;&nbsp;6 Month Delay for Specified Employees. </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(i)&nbsp;&nbsp;&nbsp;&nbsp;If Employee is a &#147;specified employee&#148;, then no payment or benefit that is payable on account of
Employee&#146;s &#147;separation from service&#148;, as that term is defined for purposes of Section&nbsp;409A, shall be made before the date that is six months after Employee&#146;s &#147;separation from service&#148; (or, if earlier, the date of
Employee&#146;s death) if </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">9 </FONT></P>


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and to the extent that such payment or benefit constitutes deferred compensation (or may be nonqualified deferred compensation) under Section&nbsp;409A and such deferral is required to comply
with the requirements of Section&nbsp;409A. Any payment or benefit delayed by reason of the prior sentence shall be paid out or provided in a single lump sum at the end of such required delay period in order to catch up to the original payment
schedule. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(ii)&nbsp;&nbsp;&nbsp;&nbsp;For purposes of this provision, Employee shall be considered to be a
&#147;specified employee&#148; if, at the time of her or her separation from service, Employee is a &#147;key employee&#148;, within the meaning of Section&nbsp;416(i) of the Code, of Employer (or any person or entity with whom Employer would be
considered a single employer under Section&nbsp;414(b) or Section&nbsp;414(c) of the Code) any stock in which is publicly traded on an established securities market or otherwise. </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(iii)&nbsp;&nbsp;&nbsp;&nbsp;Unless otherwise required to comply with Section&nbsp;409A, a payment or benefit shall not be
deferred pursuant to this provision if: </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:13%; text-indent:4%;padding-bottom:0px; "><FONT STYLE="font-family:Times New Roman" SIZE="2">(x)&nbsp;&nbsp;&nbsp;&nbsp;it is not made on
account of Employee&#146;s &#147;separation from service&#148;, (y) it is required to be paid no later than within 2<FONT SIZE="1"><SUP STYLE="vertical-align:baseline; position:relative; bottom:.8ex">&nbsp;1</SUP></FONT><FONT SIZE="2">/</FONT><FONT
SIZE="1"><SUB STYLE="vertical-align:baseline; position:relative; top:.1ex">2</SUB></FONT><FONT STYLE="font-family:Times New Roman" SIZE="2"> months after the end of the taxable year of Employee in which the payment or benefit is no longer subject to
a &#147;substantial risk of forfeiture&#148;, as that term is defined for purposes of Section&nbsp;409A, or (z)&nbsp;the payment satisfies the following requirements: (A)&nbsp;it is being paid or provided due to Employer&#146;s termination of
Employee&#146;s employment without Cause (Section 4.4) or Employee&#146;s termination of employment after a Change in Control for the reasons set forth in Section&nbsp;4.7 hereof, (B)&nbsp;it does not exceed two times the lesser of
(1)&nbsp;Employee&#146;s annualized compensation from Employer for the calendar year prior to the calendar year in which the termination of Employee&#146;s employment occurs, and (2)&nbsp;the maximum amount of compensation that may be taken into
account under a qualified plan pursuant to Section&nbsp;401(a)(17) of the Code for the year in which Employee&#146;s employment terminates, and (C)&nbsp;the payment is required under this Agreement to be paid no later than the last day of the second
calendar year following the calendar year in which Employee incurs a &#147;separation from service&#148;. </FONT></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(d)&nbsp;&nbsp;&nbsp;&nbsp;No Acceleration of Payments. Neither Employer nor Employee, individually or in combination, may
accelerate any payment or benefit that is subject to Section&nbsp;409A, except in compliance with Section&nbsp;409A and the provisions of this Agreement, and no amount shall be paid prior to the earliest date on which it may be paid without
violating Section&nbsp;409A. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(e)&nbsp;&nbsp;&nbsp;&nbsp;Treatment of Each Installment as a Separate Payment.
For purposes of applying the provisions of Section&nbsp;409A to this Agreement, each separately identified amount to which Employee is entitled under this Agreement shall be treated as a separate payment. In addition, to the extent permissible under
Section&nbsp;409A, any series of installment payments under this Agreement shall be treated as a right to a series of separate payments. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">10 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(f)&nbsp;&nbsp;&nbsp;&nbsp;Reimbursements and
<FONT STYLE="white-space:nowrap">In-Kind</FONT> Benefits. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(i)&nbsp;&nbsp;&nbsp;&nbsp;Any reimbursements by
Employer to Employee of any eligible expenses pursuant to Section&nbsp;3.1 or 5.8 of this Agreement, that are not excludible from Employee&#146;s income for Federal income tax purposes (&#147;Taxable Reimbursements&#148;) shall be made on or before
the last day of the taxable year of Employee following the year in which the expense was incurred. </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(ii)&nbsp;&nbsp;&nbsp;&nbsp;The amount of any Taxable Reimbursements, and the value of any
<FONT STYLE="white-space:nowrap">in-kind</FONT> benefits to be provided to Employee under this Agreement, during any taxable year of Employee shall not affect the expenses eligible for reimbursement, or
<FONT STYLE="white-space:nowrap">in-kind</FONT> benefits to be provided, in any other taxable year of Employee. </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(iii)&nbsp;&nbsp;&nbsp;&nbsp;The right to Taxable Reimbursements, or <FONT STYLE="white-space:nowrap">in-kind</FONT>
benefits, shall not be subject to liquidation or exchange for another benefit. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.13.&nbsp;&nbsp;&nbsp;&nbsp;<I>Release.
</I>Employer shall provide Employee with a general release in the form attached as Exhibit C (subject to such modifications as Employer may reasonably request) within seven (7)&nbsp;days after Employee&#146;s termination date.&nbsp;Payments or
benefits to which Employee may be entitled pursuant to this Section&nbsp;5 (other than any accrued but unpaid Base Salary and employee benefits as of the end of the Employment Period) (the &#147;Severance Amounts&#148;) shall be conditioned upon
Employee executing the general release within 21 days after receiving it from Employer and the general release becoming irrevocable upon the expiration of 7 days following the Employee&#146;s execution of it. Payment of the Severance Amounts shall
be suspended during the period (the &#147;Suspension Period&#148;) that begins on Employee&#146;s termination date and ends on the date (&#147;Suspension Termination Date&#148;) that is thirty-five (35)&nbsp;days after Employee&#146;s termination
date; provided, however, that this suspension shall not apply, and Employer shall be required to provide, any continued health insurance coverage that would be required under Section&nbsp;5.9 hereof during the Suspension Period. If Employee executes
the general release and the general release becomes irrevocable by no later than the Suspension Termination Date, then payment of any Severance Amounts that were suspended pursuant to this provision shall be made in the first payroll period that
follows the Suspension Termination Date, and any Severance Amounts that are payable after the Suspension Termination Date shall be paid at the times provided in Section&nbsp;5. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.14.&nbsp;&nbsp;&nbsp;&nbsp;<I>Vesting of Incentive Awards. </I>Notwithstanding any contrary provision in this Agreement or<B> </B>any
Equity Plan then maintained by Mednax: </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a) all Equity Awards granted to Employee by Mednax prior to termination of this
Agreement shall continue to vest until fully vested following a termination of Employee&#146;s employment pursuant to Section&nbsp;4.2, 4.3, and 4.5;<B> </B>and </FONT></P>
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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(b) in the event of a Change in Control after the date of this Agreement: </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(i)&nbsp;&nbsp;&nbsp;&nbsp;if, prior to the one (1)&nbsp;year anniversary of the effective date of such Change in Control,
the employment by Mednax or its affiliates or successors of both Roger J. Medel, M.D. and Joseph M. Calabro is terminated for any reason, or they both no longer hold the positions they held just prior to the Change in Control (and neither holds the
top executive position in the company), then the Equity Awards granted to the Employee that are outstanding (the &#147;Accelerated Awards&#148;) shall become fully vested and payable to the Employee on the first anniversary of the effective date of
such Change in Control; provided, however, that any portion of the Accelerated Awards that is scheduled to become vested and payable pursuant to its terms prior to the first anniversary of such Change in Control shall become vested and payable to
the Employee pursuant to its terms; and </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(ii) &nbsp;&nbsp;&nbsp;&nbsp;if, after the one (1)&nbsp;year
anniversary of the effective date of such Change in Control, the employment by Mednax or its affiliates or successors of both Roger J. Medel, M.D. and Joseph M. Calabro is terminated for any reason, or they both no longer hold the positions they
held just prior to the Change in Control (provided that neither holds the top executive position in the company), then the Accelerated Awards shall become fully vested and payable to the Employee on the one (1)&nbsp;year anniversary of the
termination date, or date of the change in position of Roger J. Medel, M.D. or Joseph M. Calabro, whichever termination date or date in change of position is later; provided, however, that any portion of the Accelerated Awards that is scheduled to
become vested and payable pursuant to its terms prior to the one (1)&nbsp;year anniversary of such termination date or date of change in position shall become vested and payable to the Employee pursuant to its terms; </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">provided in the case of both clauses (i)&nbsp;and (ii) above, that the Employee remains in Continuous Service (as defined in the applicable Equity Plan)
from the date of this Agreement through the date on which such Accelerated Awards would vest pursuant to clauses (i)&nbsp;or (ii) above, as applicable. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(iii)&nbsp;&nbsp;&nbsp;&nbsp;if at any time after a Change in Control after the date of this Agreement, Employee&#146;s employment is terminated pursuant to Section&nbsp;4.4 or 4.7(a),(b)(d)&nbsp;(e) or
(f), then all of the Accelerated Awards will be fully vested and exercisable as of the effective date of such termination. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Notwithstanding anything to the contrary in this Agreement, the Equity Plans or the Equity Awards, in the event of a Change in Control
immediately following which neither the common stock of Mednax nor the common equity of its successor, parent or subsidiary is listed for trading on a national securities exchange (a &#147;Going Private Transaction&#148;), then all unvested Equity
Awards granted to the Employee shall be adjusted so that in lieu of the Employee&#146;s right to receive shares of common stock of Mednax pursuant to the terms of such Equity Awards, the Employee shall be entitled to receive, for each share of
common stock of Mednax that Employee would otherwise be entitled to receive pursuant to such Equity Awards, an amount of cash equal to the amount per share of common stock of Mednax paid to the shareholders of Mednax in such Going Private
Transaction, as determined by the Compensation Committee of the Board in its sole discretion, in each case consistent with the vesting schedule of such Equity Awards and shall remain subject to the acceleration provisions set forth in this
Section&nbsp;5.14. </FONT></P>
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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>6.&nbsp;&nbsp;&nbsp;&nbsp;Successors; Binding Agreement. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">6.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Successors</I>. Employer shall require any successor (whether direct or indirect, by purchase, merger,
consolidation or otherwise) acquiring a majority of Employer&#146;s voting common stock or any other successor to all or substantially all of the business and/or assets of Employer to expressly assume and agree to perform this Agreement in the same
manner and to the same extent that Employer would be required to perform it if no such succession had taken place and Employee hereby consents to any such assignment. In such event, &#147;Employer&#148; shall mean Employer as previously defined and
any successor to its business and/or assets which executes and delivers the agreement provided for in this Section&nbsp;6 or which otherwise becomes bound by all the terms and provisions of this Agreement by operation of law. This Section shall not
limit Employee&#146;s ability to terminate this Agreement in the circumstances described in Section&nbsp;4.7 in the event of a Change in Control. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">6.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>Benefit</I>. This Agreement and all rights of Employee under this Agreement shall inure to the benefit of and be enforceable by Employee&#146;s personal or legal
representatives, executors, administrators, successors, heirs, distributees, devisees and legatees. If Employee should die after the termination date and amounts would have been payable to Employee under this Agreement if Employee had continued to
live, including under Section&nbsp;5 hereof, then such amounts shall be paid to Employee&#146;s devisee, legatee, or other designee or, if there is no such designee, Employee&#146;s estate. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>7.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Conflicts with Prior Employment Contract. </B>Except as otherwise provided in this Agreement with
respect to the May&nbsp;26, 2018 expiration of the Prior Employment Agreement, this Agreement constitutes the entire agreement among the parties pertaining to the subject matter hereof, and supersedes and revokes any and all prior or existing
agreements, written or oral, relating to the subject matter hereof, and this Agreement shall be solely determinative of the subject matter hereof. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>8.&nbsp;&nbsp;&nbsp;&nbsp;Restrictive Covenants; Confidential Information; Work Product; Injunctive Relief. </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">8.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>No Material Competition</I>. Employer and Employee acknowledge and agree that a strong relationship and connection exists between Employer and its current and prospective
patients, referral sources, and customers as well as the hospitals and healthcare facilities at which it provides professional services. Employer and Employee further acknowledge and agree that the restrictive covenants described in this Section are
designed to enforce, and are ancillary to or part of, the promises contained in this Agreement and are reasonably necessary to protect the legitimate interests of Employer in the following: (1)&nbsp;the use and disclosure of the Confidential
Information as described in Section&nbsp;8.4; (2) the professional development activities described in Section&nbsp;1.2; and (3)&nbsp;the goodwill of the Employer, as promoted by Employee as provided in Section&nbsp;1.2. The foregoing listing is by
way of example only and shall not be construed to be an exclusive or exhaustive list of such interests. Employee acknowledges that the restrictive covenants set forth below are of significant value to Employer and were a material inducement to
Employer in agreeing to the terms of this Agreement. Employee further acknowledges that the goodwill and other proprietary interest of Employer will suffer irreparable and continuing damage in the event Employee enters into competition with Employer
in violation of this Section. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">13 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">Therefore, Employee agrees that, except with respect to services performed under this Agreement on behalf of
Employer, <B>Employee shall not</B>, at any time during the Restricted Period (as defined below), for Employee or on behalf of any other person, persons, firm, partnership, corporation or employer, participate or engage in or own an interest in,
directly or indirectly, any individual proprietorship, partnership, corporation, joint venture, trust or other form of business entity, whether as an individual proprietor, partner, joint venturer, officer, director, member, employee, consultant,
independent contractor, stockholder, lender, landlord, finder, agent, broker, trustee, or in any manner whatsoever, if such entity or its affiliates is engaged in, directly or indirectly, &#147;Employer&#146;s Business,&#148; as defined on Exhibit A
hereto. Employee acknowledges that, as of the date hereof, Employee&#146;s responsibilities will include matters affecting the businesses of Employer listed on Exhibit A. For purposes of this Section&nbsp;8, the &#147;Restricted Period&#148; shall
mean the Employment Period plus (i)&nbsp;eighteen (18) months in the event this Agreement is terminated pursuant to Sections 4.1, 4.7(a), 4.7(b), 4.7(d), 4.7(e), or 4.7(f) or (ii)&nbsp;twenty-four (24)&nbsp;months in the event the Agreement is
terminated for any other reason. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>No Hire</I>. Employee further agrees that <B>Employee shall
not</B>, at any time during the Employment Period and for a period of eighteen (18)&nbsp;months immediately following termination of this Agreement for any reason, for Employee or on behalf of any other person, persons, firm, partnership,
corporation or employer, employ, or knowingly permit any company or business directly or indirectly controlled by Employee to employ or otherwise engage (a)&nbsp;any person who is a then current employee or independent contractor of Employer or one
of its affiliates, or (b)&nbsp;any person who was an employee or independent contractor of Employer or one of its affiliates in the prior six (6)&nbsp;month period, or in any manner seek to induce such persons to leave his or her employment or
engagement with Employer or one of its affiliates (including without limitation for or on behalf of a subsequent employer of Employee). </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">8.3 <I><FONT STYLE="white-space:nowrap">Non-solicitation.</FONT> </I>Employee further agrees that <B>Employee shall not</B>, at any time during the Employment Period and for a period of eighteen
(18)&nbsp;months immediately following termination of this Agreement for any reason, for Employee or on behalf of any other person, persons, firm, partnership, corporation or employer, solicit or accept business from or take any action that would
interfere with, diminish or impair the valuable relationships that Employer or its affiliates have with (i)&nbsp;hospitals or other health care facilities with which Employer or its affiliates have contracts to render professional services or
otherwise have established relationships, (ii)&nbsp;patients, (iii) referral sources, (iv)&nbsp;vendors, (v) any other clients of Employer or its affiliates, or (vi)&nbsp;prospective hospitals, patients, referral sources, vendors or clients whose
business Employee was aware that Employer or any affiliate of Employer was in the process of soliciting at the time of Employee&#146;s termination (including potential acquisition targets). </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.4.&nbsp;&nbsp;&nbsp;&nbsp;<I>Confidential Information</I>. At all times during the term of this Agreement, Employer shall provide
Employee with access to &#147;Confidential Information.&#148; As used in this Agreement, the term &#147;Confidential Information&#148; means any and all confidential, proprietary or trade secret information, whether disclosed, directly or
indirectly, verbally, in writing or by any other means in tangible or intangible form, including that which is conceived or developed by Employee, applicable to or in any way related to: (i)&nbsp;patients with whom Employer has a physician/patient
relationship; (ii)&nbsp;the present or future business of Employer; or (iii)&nbsp;the research and development of </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">14 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
Employer. Without limiting the generality of the foregoing, Confidential Information includes: (a)&nbsp;the development and operation of Employer&#146;s medical practices, including information
relating to budgeting, staffing needs, marketing, research, hospital relationships, equipment capabilities, and other information concerning such facilities and operations and specifically including the procedures and business plans developed by
Employer for use at the hospitals where Employer conducts its business; (b)&nbsp;contractual arrangements between the Employer and insurers or managed care associations or other payors; (c)&nbsp;the databases of Employer; (d)&nbsp;the clinical and
research protocols of Employer, including coding guidelines; (e)&nbsp;the referral sources of Employer; (f)&nbsp;other confidential information of Employer that is not generally known to the public that gives Employer the opportunity to obtain an
advantage over competitors who do not know or use it, including the names, addresses, telephone numbers or special needs of any of its patients, its patient lists, its marketing methods and related data, lists or other written records used in
Employer&#146;s business, compensation paid to employees and other terms of employment, accounting ledgers and financial statements, contracts and licenses, business systems, business plan and projections, and computer programs. The parties agree
that, as between them, this Confidential Information constitutes important, material, and confidential trade secrets that affect the successful conduct of Employer&#146;s business and its goodwill. Employer acknowledges that the Confidential
Information specifically enumerated above is special and unique information and is not information that would be considered a part of the general knowledge and skill Employee has or might otherwise obtain. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Notwithstanding the foregoing, Confidential Information shall not include any information that (i)&nbsp;was known by Employee from a
third party source before disclosure by or on behalf of Employer, (ii)&nbsp;becomes available to Employee from a source other than Employer that is not, to Employee&#146;s knowledge, bound by a duty of confidentiality to Employer, (iii)&nbsp;becomes
generally available or known in the industry other than as a result of its disclosure by Employee, or (iv)&nbsp;has been independently developed by Employee and may be disclosed by Employee without breach of this Agreement, provided, in each case,
that the Employee shall bear the burden of demonstrating that the information falls under one of the above-described exceptions. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Employee agrees that the terms of this Agreement shall be deemed Confidential Information for purposes of this Section. Employee shall keep the terms of this Agreement strictly confidential and will not,
without the prior written consent of Employer, disclose the details of this Agreement to any third party in any manner whatsoever in whole or in part, with the exception of Employee&#146;s representatives (such as tax advisors and attorneys) who
need to know such information. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Employee agrees that Employee will not at any time, whether during or subsequent to the term
of Employee&#146;s employment with Employer, in any fashion, form or manner, unless specifically consented to in writing by Employer, either directly or indirectly, use or divulge, disclose, or communicate to any person, firm or corporation, in any
manner whatsoever, any Confidential Information of any kind, nature, or description, subject to applicable law. The parties agree that any breach by Employee of any term of this Section is a material breach of this Agreement and shall constitute
&#147;cause&#148; for the termination of Employee&#146;s employment hereunder. In the event that Employee is ordered to disclose any Confidential Information, whether in a legal or a regulatory proceeding or otherwise, Employee shall provide
Employer with prompt written notice of such request or order so that Employer may seek to prevent disclosure or, if that cannot be achieved, the entry of a protective order or other appropriate protective device or procedure in order to assure, to
</FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">15 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
the extent practicable, compliance with the provisions of this Agreement. In the case of any disclosure required by law, Employee shall disclose only that portion of the Confidential Information
that Employee is ordered to disclose in a legally binding subpoena, demand or similar order issued pursuant to a legal or regulatory proceeding. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">All Confidential Information, and all equipment, notebooks, documents, memoranda, reports, files, samples, books, correspondence, lists, other written and graphic records, in any media (including
electronic or video) containing Confidential Information or relating to the business of Employer, which Employee shall prepare, use, construct, observe, possess, or control shall be and remain Employer&#146;s sole property (collectively
&#147;Employer Property&#148;). Upon termination or expiration of this Agreement, or earlier upon Employer&#146;s request, Employee shall promptly deliver to Employer all Employer Property, retaining none. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.5.&nbsp;&nbsp;&nbsp;&nbsp;<I>Ownership of Work Product.</I> Employee agrees and acknowledges that (i)&nbsp;all copyrights, patents,
trade secrets, trademarks, service marks, or other intellectual property or proprietary rights associated with any ideas, concepts, techniques, inventions, processes, or works of authorship developed or created by Employee during the course of
performing work for Employer and any other work product conceived, created, designed, developed or contributed by Employee during the term of this Agreement that relates in any way to Employer&#146;s Business (collectively, the &#147;Work
Product&#148;), shall belong exclusively to Employer and shall, to the extent possible, be considered a work made for hire within the meaning of Title 17 of the United States Code. To the extent the Work Product may not be considered a work made for
hire owned exclusively by Employer, Employee hereby assigns to Employer all right, title, and interest worldwide in and to such Work Product at the time of its creation, without any requirement of further consideration. Upon request of Employer,
Employee shall take such further actions and execute such further documents as Employer may deem necessary or desirable to further the purposes of this Agreement, including without limitation separate assignments of all right, title, and interest in
and to all rights of copyright and all right, title, and interest in and to any inventions or patents and any reissues or extensions which may be granted therefore, and in and to any improvements, additions to, or modifications thereto, which
Employee may acquire by invention or otherwise, the same to be held and enjoyed by Employer for its own use and benefit, and for the use and benefit of Employer&#146;s successors and assigns, as fully and as entirely as the same might be held by
Employee had this assignment not been made. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.6.&nbsp;&nbsp;&nbsp;&nbsp;<I>Clearance Procedure for Proprietary Rights Not
Claimed by Employer.</I> In the event that Employee wishes to create or develop, <I>other than</I> on Employer&#146;s time or using Employer&#146;s resources, anything that may be considered Work Product but to which Employee believes Employee
should be entitled to the personal benefit of, Employee agrees to follow the clearance procedure set forth in this Section. Before beginning any such work, Employee agrees to give Employer advance written notice and provide Employer with a
sufficiently detailed written description of the work under consideration for Employer to make a determination regarding the work. Unless otherwise agreed in a writing signed by Employer prior to receipt, Employer shall have no obligation of
confidentiality with respect to such request or description. Employer will determine in its sole discretion, within thirty (30)&nbsp;days after Employee has fully disclosed such plans to Employer, whether rights in such work will be claimed by
Employer. If Employer determines that it does not claim rights in such work, Employer agrees to so notify Employee in writing and </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">16 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
Employee may retain ownership of the work to the extent that such work has been expressly disclosed to Employer. If Employer fails to so notify Employee within such thirty (30)&nbsp;day period,
then Employer shall be deemed to have agreed that such work is not considered Work Product for purposes of this Agreement. Employee agrees to submit for further review any significant improvement, modification, or adaptation that could reasonably be
related to Employer&#146;s Business so that it can be determined whether the improvement, modification, or adaptation relates to the business or interests of Employer. Clearance under this procedure does not relieve Employee of the restrictive
covenants set forth in this Section&nbsp;8. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.7.&nbsp;&nbsp;&nbsp;&nbsp;<I><FONT STYLE="white-space:nowrap">Non-Disparagement.</FONT></I> For a period of ten (10)&nbsp;years after
the termination of this Agreement, Employee will not, directly or indirectly, as an individual or on behalf of a firm, corporation, partnership or other legal entity, make any disparaging or negative comment to any other person or entity regarding
Employer or any of its affiliates, agents, attorneys, employees, officers and directors, Employee&#146;s work conditions or circumstances surrounding Employee&#146;s separation from Employer or otherwise impugn or criticize the name or reputation of
Employer, its affiliates, agents, attorneys, employees, officers or directors, orally or in writing. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.8.&nbsp;&nbsp;&nbsp;&nbsp;<I>Review by Employee.</I> <B>Employee has carefully read and considered the terms and provisions of this
Section</B><B></B><B>&nbsp;8, and having done so, agrees that the restrictions set forth in this Section</B><B></B><B>&nbsp;8 are fair and reasonably required for the protection of the interests of Employer.</B> In the event that any term or
provision set forth in this Section&nbsp;8 shall be held to be invalid or unenforceable by a court of competent jurisdiction, the parties hereto agree that such invalid or unenforceable term(s) or provision(s) may be severed from this Agreement
without, in any manner, affecting the remaining portions hereof. Without limiting other possible remedies available to Employer, Employee agrees that injunctive or other equitable relief will be available to enforce the covenants set forth in this
Section, such relief to be without the necessity of posting a bond. In the event that, notwithstanding the foregoing, any part of the covenants set forth in this Section shall be held to be invalid, overbroad, or unenforceable by an arbitration
panel or a court of competent jurisdiction, the parties hereto agree that such invalid, overbroad, or unenforceable provision(s) may be modified or severed from this Agreement without, in any manner, affecting the remaining portions of this
Section&nbsp;8 (all of which shall remain in full force and effect). In the event that any provision of this Section&nbsp;8 related to time period or areas of restriction shall be declared by an arbitration panel or a court of competent jurisdiction
to exceed the maximum time period, area or activities such arbitration panel or court deems reasonable and enforceable, said time period or areas of restriction shall be deemed modified to the minimum extent necessary to make the geographic or
temporal restrictions or activities reasonable and enforceable. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.9.&nbsp;&nbsp;&nbsp;&nbsp;<I>Survival.</I> The provisions
of this Section&nbsp;8 shall survive the termination of this Agreement and Employee&#146;s employment with Employer.<B> </B>The provisions of this Section&nbsp;8 shall apply during the time Employee is receiving Disability payments from Employer as
a result of a termination of this Agreement pursuant to Section&nbsp;4.2 hereof.<B> </B>In the event of a breach of this Section&nbsp;8 by Employee, Employer retains the right to terminate any continuing payments to Employee provided for in
Section&nbsp;5 of this Agreement. The provisions of this Section&nbsp;8 are expressly intended to benefit and be enforceable by other affiliated entities of Employer, who are express third party beneficiaries hereof. Employee shall not assist others
in engaging in any of the activities described in the foregoing restrictive covenants. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">17 </FONT></P>



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 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>9.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Arbitration. </B>Any controversy or claim arising out of or
relating to this Agreement, or any alleged breach hereof shall be finally determined by binding arbitration before a three member panel, consisting of one member selected by each party hereto, with the third member selected by the first two
arbitrators. Each party hereto shall bear the costs of its own nominee, and shall share equally the cost of the third arbitrator and the parties agree that the costs of arbitration shall not be subject to reapportionment by the arbitration panel.
The arbitration proceedings shall be held in Sunrise, Florida, unless otherwise mutually agreed by the parties, and shall be conducted in accordance with the American Arbitration Association National Rules for the Resolution of Employment Disputes
then in effect. Judgment on the award rendered by the arbitration panel may be entered and enforced by any court having jurisdiction thereof. Notwithstanding anything herein to the contrary, if the Employer shall require immediate injunctive relief,
then the Employer shall be entitled to seek such relief in any court having jurisdiction, and if the Employer elects to do so, the Employee hereby consents to the jurisdiction of the state and federal courts sitting in the State of Florida and to
the applicable service of process. Employee hereby waives and agrees not to assert, to the fullest extent permitted by applicable law, any claim that (i)&nbsp;Employee is not subject to the jurisdiction of such courts, (ii)&nbsp;Employee is immune
from any legal process issued by such courts and (iii)&nbsp;any litigation or other proceeding commenced in such courts is brought in an inconvenient forum. Any such arbitration shall be treated as confidential by all parties thereto, except as
otherwise provided by law or as otherwise necessary to enforce any judgment or order issued by the arbitrators. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>10.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Governing Law.</B> This Agreement shall be governed by and construed in accordance with the laws of the
State of Florida without regard to its conflict of laws principles to the extent that such principles would require the application of laws other than the laws of the State of Florida. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>11.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Notices.</B> Any notice required or permitted to be given under this Agreement shall be in writing and
shall be deemed to have been given when delivered by hand or when deposited in the United States mail by registered or certified mail, return receipt requested, postage prepaid, addressed as follows: </P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="90%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="51%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD WIDTH="47%"></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom">If to Employer:</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">If to Employee:</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom">Mednax Services, Inc.</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">Vivian Lopez-Blanco</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom">1301 Concord Terrace</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">c/o Mednax Services, Inc.</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom">Sunrise, FL 33323</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">1301 Concord Terrace </P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom">Attention: General Counsel</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">Sunrise, FL 33323</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">or to such other addresses as either party hereto may from time to time give notice of to the other in the aforesaid manner.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>12.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Benefits: Binding Effect.</B> This Agreement shall be for the benefit of and binding upon the
parties hereto and their respective heirs, personal representatives, legal representatives, successors and, where applicable, assigns. Notwithstanding the foregoing, Employee may not assign the rights or benefits hereunder without the prior written
consent of Employer. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">18 </P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>13.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Severability. </B>The invalidity of any one or more of
the words, phrases, sentences, clauses or sections contained in this Agreement shall not affect the enforceability of the remaining portions of this Agreement or any part thereof, all of which are inserted conditionally on their being valid in law,
and, in the event that any one or more of the words, phrases, sentences, clauses or sections contained in this Agreement shall be declared invalid, this Agreement shall be construed as if such invalid word or words, phrase or phrases, sentence or
sentences, clause or clauses, or section or sections had not been inserted. If such invalidity is caused by length of time or size of area, or both, the otherwise invalid provision will be considered to be reduced to a period or area, which would
cure such invalidity. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>14.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Waivers. </B>The waiver by either party hereto of a breach or
violation of any term or provision of this Agreement shall not operate nor be construed as a waiver of any subsequent breach or violation. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>15.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Damages. </B>Nothing contained herein shall be construed to prevent Employer or Employee from seeking and recovering from the other damages sustained by either or both
of them as a result of a breach of any term or provision of this Agreement. In the event that either party hereto brings suit for the collection of any damages resulting from, or the injunction of any action constituting, a breach of any of the
terms or provisions of this Agreement, then the party found to be at fault shall pay all reasonable court costs and attorneys&#146; fees of the other, whether such costs and fees are incurred in a court of original jurisdiction or one or more courts
of appellate jurisdiction. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>16.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>No Third Party Beneficiary. </B>Except as provided in
Section&nbsp;8.9, nothing expressed or implied in this Agreement is intended, or shall be construed, to confer upon or give any person (other than the parties hereto and, in the case of Employee, Employee&#146;s heirs, personal representative(s)
and/or legal representative) any rights or remedies under or by reason of this Agreement. No agreements or representations, oral or otherwise, express or implied, have been made by either party with respect to the subject matter of this Agreement
which agreements or representations are not set forth expressly in this Agreement, and this Agreement supersedes any other employment agreement between Employer and Employee. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>17.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Assignment.</B> This Agreement may be assigned by Employer upon notice to Employee. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><I>The remainder of this page has been left blank intentionally. </I></FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">19 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>IN WITNESS WHEREOF</B>, the undersigned have executed this Agreement this 12th day of
February, 2018, effective as of the Effective Date. </FONT></P> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TR>
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<TD WIDTH="44%"></TD>
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<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>EMPLOYER:</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="3"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>EMPLOYEE:</B></FONT></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8" COLSPAN="3"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>MEDNAX SERVICES, INC.</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
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<TD HEIGHT="16"></TD>
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<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
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<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">By:</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"> <P STYLE="margin-top:0px;margin-bottom:1px;border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="2">/s/ Manuel Kadre</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">By:</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"> <P STYLE="margin-top:0px;margin-bottom:1px;border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="2">/s/ Vivian Lopez-Blanco</FONT></P></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">Manuel Kadre</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">Vivian Lopez-Blanco</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">Chairman, Compensation Committee</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD></TR>
</TABLE>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">20 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>EXHIBIT A </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>BUSINESS OF EMPLOYER </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">As of the date hereof, Employer, directly or through
its affiliates, provides professional medical services and all aspects of practice management services in medical practice areas that include, but are not limited to, the following (collectively referred to herein as &#147;Employer&#146;s
Business&#148;): </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(1) Neonatology, including hospital well baby care; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(2) Maternal-Fetal Medicine, including general obstetrics services; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(3) Pediatric Cardiology;
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(4) Pediatric Intensive Care, including Pediatric Hospitalist Care; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(5) Newborn hearing screening services; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(6) Pediatric Surgery; </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(7) Pediatric Emergency Medicine; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(8)
Anesthesiology, critical care medicine and pain management; and </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(9) Radiology and Teleradiology. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">References to Employer&#146;s Business in this Agreement shall include such other medical service lines, practice management services and
other businesses in which Employer is engaged during the Employment Period; <I>provided,</I> that to be considered a part of Employer&#146;s Business, Employer must have engaged in such other service line, practice management service or other
business at least six (6)&nbsp;months prior to the termination date of this Agreement. For purposes of this Exhibit A, businesses of Employer shall include the businesses conducted by Employer&#146;s subsidiaries, entities under common control and
affiliates as defined under Rule 144 of the Securities Act of 1933, as amended. Such affiliates shall include the professional corporations and associations whose operating results are consolidated with Employer for financial reporting purposes.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Notwithstanding the foregoing, Employer acknowledges and agrees to the following exceptions and clarifications regarding the
scope of Employer&#146;s Business. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">A.&nbsp;&nbsp;&nbsp;&nbsp;<I>Hospital Services. </I>Employer and Employee acknowledge
that, as of the date hereof, Employer does not currently operate hospitals, hospital systems or universities. Nevertheless, the businesses of hospitals, hospital systems and universities would be the same as Employer&#146;s Business where such
hospitals, hospital systems or universities provide or contract with others to provide some or all of the medical services included in Employer&#146;s Business. Therefore, the parties desire to clarify their intent with respect to the limitations on
Employee&#146;s ability to work for or contract with others to provide services for a hospital, hospital system or university during the Employment Period and during the Restricted Period. Section&nbsp;8.1 shall not be deemed to restrict
Employee&#146;s ability to work for a hospital, hospital system or university if the hospital, hospital system or university does not provide any of the medical services included in Employer&#146;s Business. Furthermore, even if a hospital, hospital
system or university provides medical services that are included in Employer&#146;s Business, Employee may work for such hospital, hospital system or university if Employee has no direct supervisory responsibility for or involvement in the
hospital&#146;s, </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">21 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
hospital system&#146;s or university&#146;s medical services that are Employer&#146;s Business. Finally, Employer agrees that Employee may hold direct supervisory responsibility for or be
involved in the medical services of a hospital, hospital system or university that are included in Employer&#146;s Business so long as such hospital, hospital system or university is located at least ten (10)&nbsp;miles from a medical practice owned
or operated by Employer or its affiliate. Subject to paragraph B below, the provisions of this paragraph shall not apply to the extent that, after the date hereof, Employer enters into the business of operating a hospital or hospital system.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">B.&nbsp;&nbsp;&nbsp;&nbsp;<I>De Minimus Exception. </I>Employer agrees that a medical service line (other than those listed
in items 1 through 9 above), practice management service or other business in which Employer is engaged shall not be considered to be a part of Employer&#146;s Business if such medical service line, practice management service or other business
constitutes less than Fifteen Million Dollars ($15,000,000) of Employer&#146;s annual revenues. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">C.&nbsp;&nbsp;&nbsp;&nbsp;<I>Certain Ownership Interests. </I><B></B>It shall not be deemed to be a violation of Section&nbsp;8.1 for
Employee to: (i)&nbsp;own, directly or indirectly, one percent (1%) or less of a publicly-traded entity; or (ii)&nbsp;own, directly or indirectly, less than five percent (5%) of a privately-held business or company, if Employee is at all times a
passive investor with no board representation, management authority or other special rights to control operations of such business or company.<I> </I> </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">22 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>EXHIBIT B </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>COMPENSATION </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Performance Bonus:</B> Up to One Hundred Percent (100%) of
Employee&#146;s Base Salary </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Equity Compensation: </B>Employee shall be eligible for equity compensation as approved by the Compensation
Committee of the Board of Directors. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">23 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>EXHIBIT C </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>FORM OF RELEASE </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>GENERAL RELEASE OF CLAIMS </I></B></FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">1.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
(&#147;<U>Employee</U>&#148;), for herself and her family, heirs, executors, administrators, legal representatives and their respective successors and assigns, in exchange for the consideration received pursuant to
Section&nbsp;5.[&nbsp;&nbsp;&nbsp;&nbsp;] of the Employment Agreement to which this release is attached as Exhibit C (the &#147;<U>Employment Agreement</U>&#148;), does hereby release and forever discharge
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (&#147;<U>Employer</U>&#148;), its subsidiaries, affiliated companies, successors and assigns, and its current or former
directors, officers, employees, shareholders or agents in such capacities (collectively with Employer, the &#147;<U>Released Parties</U>&#148;) from any and all actions, causes of action, suits, controversies, claims and demands whatsoever, for or
by reason of any matter, cause or thing whatsoever, whether known or unknown including, but not limited to, all claims under any applicable laws arising under or in connection with Employee&#146;s employment or termination thereof, whether for
discrimination, harassment, retaliation, tort, breach of express or implied employment contract, wrongful discharge, intentional infliction of emotional distress, or defamation or injuries incurred on the job or incurred as a result of loss of
employment. Employee acknowledges that Employer encouraged her to consult with an attorney of her choosing, and through this General Release of Claims encourages Employee to consult with her attorney with respect to possible claims under the Age
Discrimination in Employment Act (&#147;<U>ADEA</U>&#148;) and that she understands that the ADEA is a Federal statute that, among other things, prohibits discrimination on the basis of age in employment and employee benefits and benefit plans.
Without limiting the generality of the release provided above, Employee expressly waives any and all claims under ADEA that she may have as of the date hereof. Employee further understands that by signing this General Release of Claims she is in
fact waiving, releasing and forever giving up any claim under the ADEA as well as all other laws within the scope of this paragraph 1 that may have existed on or prior to the date hereof. Notwithstanding anything in this paragraph 1 to the contrary,
this General Release of Claims shall not apply to (i)&nbsp;any actions to enforce rights to receive any payments or benefits which may be due Employee pursuant to Section&nbsp;5.[&nbsp;&nbsp;&nbsp;&nbsp;] of the Employment Agreement, or under any of
Employer&#146;s employee benefit plans, (ii)&nbsp;any rights or claims that may arise as a result of events occurring after the date this General Release of Claims is executed, (iii)&nbsp;any indemnification rights Employee may have as a former
officer or director of Employer or its subsidiaries or affiliated companies, (iv)&nbsp;any claims for benefits under any directors&#146; and officers&#146; liability policy maintained by Employer or its subsidiaries or affiliated companies in
accordance with the terms of such policy, and (v)&nbsp;any rights as a holder of equity securities of Employer. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.&nbsp;&nbsp;&nbsp;&nbsp;Employee represents that she has not filed against the Released Parties any complaints, charges, or lawsuits
arising out of her employment, or any other matter arising on or prior to the date of this General Release of Claims, and covenants and agrees that she will never individually or with any person file, or commence the filing of, any charges,
lawsuits, complaints or proceedings with any governmental agency, or against the Released Parties with respect to any of the matters released by Employee pursuant to paragraph 1 hereof (a &#147;<U>Proceeding</U>&#148;). </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">24 </FONT></P>



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 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">3.&nbsp;&nbsp;&nbsp;&nbsp;Notwithstanding anything in this Agreement to the contrary, nothing in
this Agreement or any other agreement between Employer and Employee shall prevent Employee from filing a charge, sharing information and communicating in good faith, without prior notice to the Company, with any federal government agency having
jurisdiction over the Company or its operations, and cooperating in any investigation by any such federal government agency; However, to the maximum extent permitted by law, Employee agrees that if such an administrative claim is made, Employee
shall not be entitled to recover any individual monetary relief or other individual remedies. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">4.&nbsp;&nbsp;&nbsp;&nbsp;Employee hereby
acknowledges that Employer has informed her that she has up to <FONT STYLE="white-space:nowrap">twenty-one</FONT> (21)&nbsp;days to sign this General Release of Claims and she may knowingly and voluntarily waive that
<FONT STYLE="white-space:nowrap">twenty-one</FONT> (21)&nbsp;day period by signing this General Release of Claims earlier. Employee also understands that she shall have seven (7)&nbsp;days following the date on which she signs this General Release
of Claims within which to revoke it by providing a written notice of her revocation to Employer. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">5.&nbsp;&nbsp;&nbsp;&nbsp;Employee
acknowledges that this General Release of Claims will be governed by and construed and enforced in accordance with the internal laws of the State of Florida applicable to contracts made and to be performed entirely within such State. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">6.&nbsp;&nbsp;&nbsp;&nbsp;Employee acknowledges that she has read this General Release of Claims, that she has been advised that she should
consult with an attorney before she executes this general release of claims, and that she understands all of its terms and executes it voluntarily and with full knowledge of its significance and the consequences thereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">7.&nbsp;&nbsp;&nbsp;&nbsp;This General Release of Claims shall take effect on the eighth day following Employee&#146;s execution of this
General Release of Claims unless Employee&#146;s written revocation is delivered to Employer within seven (7)&nbsp;days after such execution. </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P><DIV ALIGN="right">
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<P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><U>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</U>, 20<U>&nbsp;&nbsp;&nbsp;&nbsp;</U></P></TD></TR>
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<TYPE>EX-10.29
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<DESCRIPTION>EX-10.29
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 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Exhibit 10.29 </B></FONT></P> <P STYLE="margin-top:24px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>EMPLOYMENT AGREEMENT </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>THIS EMPLOYMENT AGREEMENT</B> (this
&#147;Agreement&#148;) is made and entered into by and between <B>MEDNAX SERVICES, INC.</B>, a Florida corporation (&#147;Employer&#148;) and <B>DOMINIC J. ANDREANO</B> (&#147;Employee&#148;) effective as the Effective Date. </FONT></P>
<P STYLE="margin-top:24px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>RECITALS </B></FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>WHEREAS</B>,<B> </B>Employer is presently engaged in &#147;Employer&#146;s Business&#148; as defined on Exhibit A hereto; and
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>WHEREAS</B>, Employer and Employee previously entered in an Employment Agreement dated May&nbsp;10, 2012, as amended (the
&#147;Prior Employment Agreement&#148;), which will be allowed to expire by its terms on May&nbsp;9, 2018 and will not be renewed; and </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>WHEREAS</B>, Employer desires to employ Employee and benefit from Employee&#146;s contributions to Employer; and </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>WHEREAS</B>, in order to induce Employer to enter into this Agreement on the terms and conditions set forth herein (including an increase in compensation over what was provided under the Prior
Employment Agreement), and disclose its trade secrets and confidential information in connection with Employee&#146;s employment by Employer and award from time to time equity based compensation, Employee hereby agrees to be bound by the terms of
this Agreement, including the arbitration, <FONT STYLE="white-space:nowrap">non-competition</FONT> and related restrictive covenants set forth herein. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>NOW, THEREFORE</B>, in consideration of the premises and mutual covenants set forth herein, the parties agree as follows: </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>1.&nbsp;&nbsp;&nbsp;&nbsp;Employment. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">1.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Employment and Term</I>. Employer hereby agrees to employ Employee and Employee hereby agrees to serve
Employer on the terms and conditions set forth herein for an &#147;Initial Term&#148; commencing February&nbsp;12, 2018<B> </B>(the &#147;Effective Date&#148;) and continuing for a period of three (3)&nbsp;years, unless sooner terminated as
hereinafter set forth. Thereafter, the employment of Employee hereunder shall automatically renew for successive one (1)&nbsp;year periods until terminated in accordance herewith. The Initial Term and any automatic renewals shall be referred to as
the &#147;Employment Period.&#148; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">1.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>Duties of Employee</I>. During the Employment Period,
Employee shall serve as Senior Vice President, General Counsel and Secretary for Employer and MEDNAX, Inc., and perform such duties as are customary to the position Employee holds or as may be assigned to Employee from time to time by
Employee&#146;s supervisor (&#147;Employee&#146;s Supervisor&#148;); <I>provided, </I>that such duties as assigned shall be customary to Employee&#146;s role as an officer of Employer. Employee&#146;s employment shall be full-time and as such
Employee agrees to devote substantially all of Employee&#146;s attention and professional time to the business and affairs of Employer. Employee </FONT></P>

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shall perform Employee&#146;s duties honestly, diligently, competently, in good faith and in the best interest of Employer. Employee will devote best efforts to the promotion of the goodwill of
Employer and of its employees and affiliates. During the Employment Term, Employer shall promote the proficiency of Employee by, among other things, providing Employee with Confidential Information, specialized professional development programs, and
information regarding the organization, administration and operation of Employer. During the Employment Period, Employee agrees that Employee will not, without the prior written consent of Employer (which consent shall not be unreasonably withheld),
serve as a director on a corporate board of directors or in any other similar capacity for any institution other than Employer. During the Employment Period, it shall not be a violation of this Agreement to (i)&nbsp;serve on civic or charitable
boards or committees, or (ii)&nbsp;deliver lectures, fulfill speaking engagements or teach at educational institutions, so long as such activities have been approved by Employee&#146;s Supervisor and do not interfere with the performance of
Employee&#146;s responsibilities as an employee of Employer in accordance with this Agreement, including the restrictions of Section&nbsp;8 hereof. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">1.3.&nbsp;&nbsp;&nbsp;&nbsp;<I>Place of Performance</I>. Employee shall be based at Employer&#146;s offices located in Sunrise, Florida, except for required travel relating to Employer&#146;s Business.
</FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>2.&nbsp;&nbsp;&nbsp;&nbsp;Base Salary and Performance Bonus. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Base Salary</I>. Employee shall be paid an annual base salary as determined by Employee&#146;s supervisor
from time to time (the &#147;Base Salary&#148;), payable in installments consistent with Employer&#146;s customary payroll schedule and subject to applicable withholding for taxes and other Employee directed withholdings. Any increase to
Employee&#146;s Base Salary that is approved by Employee&#146;s Supervisor shall become Employee&#146;s new Base Salary for purposes of this Agreement. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">2.2.&nbsp;&nbsp;&nbsp;&nbsp;Performance Bonus. Employee shall be eligible for an annual bonus of up to the amount set forth on Exhibit B (the &#147;Performance Bonus&#148;). The amount of the actual bonus
paid to Employee, if any, shall be based upon the achievement of specific objectives to be developed and agreed upon by Employee and Employee&#146;s Supervisor each year and the performance of Employer. Except in the situations described in Sections
5.2, 5.3, 5.4, 5.5 and 5.7, the Performance Bonus shall only be payable to Employee if Employee is employed with Employer as of the date that the Performance Bonus is paid by Employer. Each Performance Bonus shall be paid in the calendar year
immediately following the calendar year in which it is earned, as soon as practicable after the audited financial statements for Employer for the year for which the bonus is earned have been released; provided, however, that if calculation of
Employee&#146;s Performance Bonus is not administratively practicable due to events beyond the control of Employer, then Employer may delay payment of the Performance Bonus provided that the payment is made during the first taxable year of Employee
in which the calculation of the amount of the payment is administratively practicable. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">2 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>3.&nbsp;&nbsp;&nbsp;&nbsp;Benefits. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Expense Reimbursement</I>. Employer shall promptly reimburse Employee for all <FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-pocket</FONT></FONT> expenses reasonably incurred by Employee during the Employment Period on behalf of or in connection with Employer&#146;s Business pursuant to the reimbursement
standards and guidelines of Employer in effect from time to time. Employee shall account for such expenses and submit reasonable supporting documentation to Employer in accordance with Employer&#146;s policies in effect from time to time.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.2&nbsp;&nbsp;&nbsp;&nbsp;<I>Employee Benefits</I>. During the Employment Period, Employee shall be entitled to participate
in such health, welfare, disability, retirement savings and other fringe benefit plans and programs (subject to the terms and conditions of such plans and programs) as may be provided from time to time to employees of Employer and to the extent that
such plans and programs are applicable to other similarly situated employees of Employer. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.3.&nbsp;&nbsp;&nbsp;&nbsp;<I>Leave Time</I>. During the Employment Period, Employee shall be entitled to paid vacation and leave days
each calendar year in accordance with the leave policies established by Employer from time to time, but in no event less than thirty-eight (38)&nbsp;days per year. Any leave time not used during each fiscal year of Employer may be carried over into
the next year to the extent permitted by Employer policy. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.4&nbsp;&nbsp;&nbsp;&nbsp;<I>Equity Plans. </I>During the
Employment Period, Employee shall be eligible to participate in MEDNAX, Inc.&#146;s Amended and Restated 2008 Incentive Compensation Plan, as amended, or any other similar plan adopted by MEDNAX, Inc. (each an &#147;Equity Plan&#148;) that provides
for the issuance of stock options, stock appreciation rights, restricted stock, deferred stock, bonus stock, awards payable in stock or any other stock based award (each an &#147;Equity Award&#148;). Employee&#146;s stock-based award each year shall
be determined by the Compensation Committee of MEDNAX, Inc.&#146;s Board of Directors based on Employee&#146;s performance and Employer&#146;s performance during the immediately preceding year and shall be at least consistent with the Compensation
Committee&#146;s determination of Employee&#146;s stock-based award in prior years. Every Equity Award made to Employee shall be subject to the terms and conditions of this Agreement, the applicable award agreement and the terms of the Equity Plan.
Employee shall also be eligible to participate in MEDNAX, Inc.&#146;s <FONT STYLE="white-space:nowrap">non-qualified</FONT> employee stock purchase plan and any successor plan. Employee acknowledges Employee&#146;s participation in the Equity Plan
pursuant to this Section&nbsp;3 is sufficient consideration for Employee to enter into this Agreement, including the restrictive covenants set forth in Section&nbsp;8 below<I>. </I> </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>4.&nbsp;&nbsp;&nbsp;&nbsp;Termination. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">4.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination for Cause</I>. Employer may terminate Employee&#146;s employment under this Agreement for Cause. As used in this Agreement, the term &#147;Cause&#148; shall
mean: </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a)&nbsp;&nbsp;&nbsp;&nbsp;Any act or omission of Employee, which is materially contrary to the business
interests, reputation or goodwill of Employer; </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(b)&nbsp;&nbsp;&nbsp;&nbsp;A material breach by Employee of
Employee&#146;s obligations under this Agreement, which breach is not promptly remedied upon written notice from Employer; </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">3 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(c)&nbsp;&nbsp;&nbsp;&nbsp;Employee&#146;s refusal to perform
Employee&#146;s duties as assigned pursuant to this Agreement other than a refusal which is remedied by Employee promptly after receipt of written notice thereof by Employer; or </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(d)&nbsp;&nbsp;&nbsp;&nbsp;Employee&#146;s failure or refusal to comply with a reasonable policy, standard or regulation
of Employer in any material respect, including but not limited to Employer&#146;s sexual harassment, other unlawful harassment, workplace discrimination or substance abuse policies. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The termination date for a termination of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.1 shall be the date specified by Employer in a written notice to Employee of
finding of Cause, which may not be retroactive. Upon any termination of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.1, Employee shall be entitled to the compensation specified in Section&nbsp;5.1 hereof.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>Disability</I>. Employer may terminate Employee&#146;s employment under this Agreement upon
the Disability (as defined below) of Employee. Subject to the requirements of applicable law, Employee shall be deemed to have a &#147;Disability&#148; for purposes of this Agreement in the event of (i)&nbsp;Employee&#146;s inability to perform
Employee&#146;s duties hereunder, with or without a reasonable accommodation, as a result of physical or mental illness or injury, and (ii)&nbsp;a determination by an independent qualified physician selected by Employer and acceptable to Employee
(which acceptance shall not be unreasonably withheld) that Employee is currently unable to perform such duties and in all reasonable likelihood such inability will continue for a period in excess of an additional ninety (90)&nbsp;or more days in any
one hundred twenty (120)&nbsp;day period. The termination date for a termination of this Agreement pursuant to this Section&nbsp;4.2 shall be the date specified by Employer in a notice to Employee, which date shall not be retroactive. Upon any
termination of this Agreement pursuant to this Section&nbsp;4.2, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.2 hereof. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.3.&nbsp;&nbsp;&nbsp;&nbsp;<I>Death</I>. Employee&#146;s employment under this Agreement shall terminate automatically upon the death of
Employee, without any requirement of notice by Employer to Employee&#146;s estate. The date of Employee&#146;s death shall be the termination date for a termination of Employee&#146;s employment under this Agreement pursuant to this
Section&nbsp;4.3. Upon any termination of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.3, Employee shall be entitled to the compensation specified in Section&nbsp;5.3 hereof. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.4.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employer Without Cause</I>. Employer may terminate Employee&#146;s employment without cause
by giving Employee written notice of such termination. The termination date shall be the date specified by Employer in such notice, which may be up to ninety (90)&nbsp;days from the date of such notice. Upon any termination of Employee&#146;s
employment under this Agreement pursuant to this Section&nbsp;4.4, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.4 hereof. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">4 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.5.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employee Due to Poor Health</I>. Employee may
terminate Employee&#146;s employment under this Agreement upon written notice to Employer if Employee&#146;s health should become impaired to any extent that makes the continued performance of Employee&#146;s duties under this Agreement hazardous to
Employee&#146;s physical or mental health or Employee&#146;s life (regardless of whether such condition would be deemed a Disability under any other Section of this Agreement), <I>provided </I>that Employee shall have furnished Employer with a
written statement from a qualified doctor to that effect, and <I>provided further</I> that, at Employer&#146;s written request and expense, Employee shall submit to a medical examination by an independent qualified physician selected by Employer and
acceptable to Employee (which acceptance shall not be unreasonably withheld), which doctor shall substantially concur with the conclusions of Employee&#146;s doctor. The termination date shall be the date specified in Employee&#146;s notice to
Employer, which date may not be earlier than thirty (30)&nbsp;days nor later than ninety (90)&nbsp;days from Employer&#146;s receipt of such notice. Upon any termination of Employee&#146;s employment under this Agreement pursuant to this
Section&nbsp;4.5, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.5 hereof. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">4.6.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employee</I>. Employee may terminate Employee&#146;s employment under this Agreement for any reason whatsoever upon not less than ninety (90)&nbsp;days prior
written notice to Employer. Upon receipt of such notice from Employee, Employer may, at its option, require Employee to terminate employment at any time in advance of the expiration of such ninety (90)&nbsp;day period. The termination date under
this Section&nbsp;4.6 shall be the date specified by Employer, but in no event more than ninety (90)&nbsp;days after Employer&#146;s receipt of notice from Employee as contemplated by this Section. Upon any termination of Employee&#146;s employment
under this Agreement pursuant to this Section&nbsp;4.6, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.6 hereof. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.7.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employee for Good Reason. </I>Employee may terminate Employee&#146;s employment hereunder
for Good Reason. For purposes of this Section, &#147;Good Reason&#148; shall mean: </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a)
&nbsp;&nbsp;&nbsp;&nbsp;a decrease in Employee&#146;s Base Salary; </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(b) &nbsp;&nbsp;&nbsp;&nbsp;a decrease in
the Performance Bonus potential utilized by Employer in determining a Performance Bonus for Employee; or </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(c)&nbsp;&nbsp;&nbsp;&nbsp;within a twenty-four (24)&nbsp;month period after a Change in Control (as defined below),
Employee is either (i)&nbsp;assigned any position, duties, responsibilities or compensation that is inconsistent with the position, duties, responsibilities or compensation of Employee prior to such Change in Control, (ii)&nbsp;required to report to
any person other than the President or Chief Executive Officer of Employer in place just prior to the Change in Control (unless Employee becomes Chief Executive Officer of Employer or its equivalent and reports directly to the Board, as defined
below), or (iii)&nbsp;required to perform services under this Agreement from another location more than twenty-five (25)&nbsp;miles from Employee&#146;s location prior to the Change in Control. For purposes of this Agreement, &#147;Change in
Control&#148; shall mean (i)&nbsp;the acquisition by a person or an entity or a group of persons and entities, directly or indirectly, of more than fifty (50%) percent of MEDNAX, Inc.&#146;s common
</FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">5 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">
stock in a single transaction or a series of transactions (hereinafter referred to as a &#147;50% Change in Control&#148;), (ii) a merger or other form of corporate reorganization of MEDNAX, Inc.
resulting in an actual or <I>de facto</I> 50% Change in Control, or (iii)&nbsp;the failure of Applicable Directors (defined below) to constitute a majority of MEDNAX, Inc.&#146;s Board of Directors (the &#147;Board&#148;) during any two
(2)&nbsp;consecutive year period after the date of this Agreement (the <FONT STYLE="white-space:nowrap">&#147;Two-Year</FONT> Period&#148;). &#147;Applicable Directors&#148; shall mean those individuals who are members of the Board at the inception
of a <FONT STYLE="white-space:nowrap">Two-Year</FONT> Period and any new director whose election to the Board or nomination for election to the Board was approved (prior to any vote thereon by the shareholders) by a vote of at least <FONT
STYLE="white-space:nowrap">two-thirds</FONT> (2/3) of the directors then still in office who either were directors at the beginning of the <FONT STYLE="white-space:nowrap">Two-Year</FONT> Period at issue or whose election or nomination for election
during such <FONT STYLE="white-space:nowrap">Two-Year</FONT> Period was previously approved as provided in this sentence; or </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(d)&nbsp;&nbsp;&nbsp;&nbsp;the assignment to Employee of any position inconsistent with the present position Employee holds, or material diminution in Employee&#146;s authority, excluding for this purpose
any isolated, insubstantial and inadvertent action not taken in bad faith and which is remedied by Employer promptly after receipt of written notice; or </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(e)&nbsp;&nbsp;&nbsp;&nbsp;the requirement by Employer that Employee be based in any office or location outside of the metropolitan area where Employer&#146;s present corporate offices are located (it
being understood that Employee may be presently based at another location), except for travel reasonably required in the performance of Employee&#146;s duties. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(f)&nbsp;&nbsp;&nbsp;&nbsp;any other action or inaction that constitutes a material breach of this Agreement by Employer. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2">If Employee desires to terminate Employee&#146;s employment under this Agreement pursuant to this Section, Employee must, within ninety (90)&nbsp;days after the occurrence of events giving rise to the
Good Reason, provide Employer with a written notice describing the Good Reason in reasonable detail. If Employer fails to cure the matter cited within thirty (30)&nbsp;days after the date of Employee&#146;s notice, then this Agreement shall
terminate as of the end of such thirty (30)&nbsp;day cure period, <I>provided, however, </I>that Employer may, at its option, require Employee to terminate employment at any time in advance of the expiration of such thirty (30)&nbsp;day cure period.
If Employee terminates Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.7, then Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.7 hereof.
</FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>5.&nbsp;&nbsp;&nbsp;&nbsp;Compensation and Benefits Upon Termination. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Cause</I>. If Employee&#146;s employment is terminated for Cause, Employer shall pay Employee&#146;s Base
Salary through the termination date specified in Section&nbsp;4.1 at the rate in effect at the termination date. Upon payment of such amounts, plus any amounts as may be due under Section&nbsp;5.8 below, Employer shall have no further obligation to
Employee under this Agreement. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">6 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>Disability</I>. In the event of Employee&#146;s Disability,
Employee shall continue to receive Employee&#146;s Base Salary for the first ninety (90)&nbsp;days of Disability. Thereafter, payments, if any, shall be administered pursuant to Employer&#146;s sponsored long-term disability policy. If
Employee&#146;s employment is terminated pursuant to Section&nbsp;4.2 in connection with Employee&#146;s Disability, Employee shall receive fifty percent (50%) of Employee&#146;s annual Base Salary at the rate in effect at the termination date,
payable in six (6)&nbsp;equal monthly installments after the termination date, plus a bonus calculated in accordance with Section&nbsp;5.11 and any amounts as may be due under Section&nbsp;5.8 and 5.9. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.3.&nbsp;&nbsp;&nbsp;&nbsp;<I>Death</I>. Upon Employee&#146;s death during the Employment Period, Employer shall pay to the person or
entity designated by Employee in a notice filed with Employer or, if no person is designated, to Employee&#146;s estate any unpaid amounts of Base Salary to the date of Employee&#146;s death, plus any amounts as may be due under Sections 5.8 and
5.11 below. Any payments Employee&#146;s spouse, beneficiaries or estate may be entitled to receive pursuant to any pension plan, employee welfare benefit plan, life insurance policy, or similar plan or policy then maintained by Employer shall be
determined and paid in accordance with the written instruments governing the respective plans and policies. In the event of Employee&#146;s death during the Employment Period, Employer shall notify Employee&#146;s designee or estate of the Equity
Awards held by Employee and the procedures pursuant to which all vested stock options may be exercised and other Equity Awards may be realized under the terms applicable to such awards. Upon full payment of all amounts required to be paid under this
Section&nbsp;5.3, Employer shall have no further obligation under this Agreement. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%;padding-bottom:0px; "><FONT STYLE="font-family:Times New Roman" SIZE="2">5.4.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employer Without Cause</I>. If Employer terminates Employee&#146;s
employment in accordance with Section&nbsp;4.4, then (i)&nbsp;Employer shall pay Employee&#146;s Base Salary through the termination date specified in Section&nbsp;4.4 at the rate in effect at such termination date, plus any amount due under
Section&nbsp;5.8 hereof; (ii)&nbsp;within thirty (30)&nbsp;days, pay Employee a bonus calculated in accordance with Section&nbsp;5.11 hereof; (iii)&nbsp;Employer shall continue to pay Employee&#146;s monthly Base Salary for a period of eighteen
(18)&nbsp;months after the termination date; (iv)&nbsp;within thirty (30)&nbsp;days of the first (1</FONT><FONT STYLE="font-family:Times New Roman" SIZE="1"><SUP STYLE="vertical-align:baseline; position:relative; bottom:.8ex">st</SUP></FONT><FONT
STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;anniversary of the termination date, pay Employee an amount equal to Employee&#146;s Average Annual Performance Bonus (as defined below); and (v)&nbsp;if applicable, Employee shall vest into the
Accelerated Awards (as defined below) as set forth in Section&nbsp;5.14 hereof. For purposes of this Agreement, &#147;Average Annual Performance Bonus&#148; shall be equal to the average of the percentage of the Performance Bonus target achieved by
Employee for the three (3)&nbsp;full calendar years prior to the termination date, and calculated based on Employee&#146;s Base Salary and target Performance Bonus in Employee&#146;s current position. <I>For illustration purposes, if Employee earned
40%, 100% and 70% of Employee&#146;s target Performance Bonus in each of the three full calendar years prior to termination, and Employee&#146;s current target Performance Bonus was 100% of Base Salary, and Base Salary was $450,000.00, then
Employee&#146;s Average Annual Performance Bonus would equal $315,000.00. ((40%+ 100% + 70%) / 3 x 100% x $450,000.00 = $315,000.00). </I>Upon payment of the amounts specified under Sections 5.4 and 5.11, Employer shall have no further obligation
under this Agreement. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.5.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employee Due to Poor Health. </I>If Employee terminates
Employee&#146;s employment under this Agreement pursuant to Section&nbsp;4.5 hereof, Employer shall pay to Employee any unpaid amounts of Base Salary to the termination date specified in Section&nbsp;4.5, plus any disability payments otherwise
payable by or pursuant to plans provided by Employer, plus any amounts as may be due under Section&nbsp;5.8 and 5.11 below. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">7 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.6.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employee</I>. If Employee&#146;s employment
under this Agreement terminates pursuant to Section&nbsp;4.6 hereof, Employer shall pay to Employee any unpaid amounts of Base Salary to the termination date specified in Section&nbsp;4.6, plus any amounts as may be due under Section&nbsp;5.8 below.
In the event that the termination date specified by Employer is less than ninety (90)&nbsp;days after the date of Employer&#146;s receipt of notice as contemplated by Section&nbsp;4.6, then Employer shall continue Employee&#146;s Base Salary for a
period of days equal to ninety (90)&nbsp;minus the number of days from Employee&#146;s notice to the termination date. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.7.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination for Good Reason.</I><B> </B>If Employee&#146;s employment under this Agreement is terminated
pursuant to Sections&nbsp;4.7(a), (b), (d), (e), or (f), then Employer shall (i)&nbsp;pay Employee&#146;s Base Salary through the termination date specified in Section&nbsp;4.7 at the rate in effect at such termination date, (ii)&nbsp;pay any
amounts as may be due under Section&nbsp;5.8 and 5.11, and (iii)&nbsp;continue to pay Employee&#146;s Base Salary for a period of twelve (12)&nbsp;months after the termination date. If this Agreement is terminated pursuant to Section&nbsp;4.7(c),
then Employer shall (i)&nbsp;pay Employee&#146;s Base Salary through the termination date specified in Section&nbsp;4.7 at the rate in effect at such termination date, (ii)&nbsp;pay any amounts as may be due under Sections 5.8 and 5.11, and
(iii)&nbsp;continue to pay Employee&#146;s Base Salary for a period of eighteen (18)&nbsp;months after the termination date. <B></B>In addition, notwithstanding any contrary provision in any Equity Plan, in the event of Employee&#146;s termination
pursuant to Section&nbsp;4.7(c), any unvested Equity Awards held by Employee on the termination date shall fully vest and in the case of stock options, become immediately exercisable. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.8.&nbsp;&nbsp;&nbsp;&nbsp;<I>Expense Reimbursement. </I>Employee shall be entitled to reimbursement for reasonable business expenses
incurred prior to the termination date, subject, however to the provisions of Section 3.1. Such reimbursement shall be made at the times and in accordance with Employer<B>&#146;</B>s normal procedures for reimbursements. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.9.&nbsp;&nbsp;&nbsp;&nbsp;<I>Continuation of Benefit Plans</I>. Employee shall be entitled to continuation of health, medical,
hospitalization and other similar health insurance programs on the same basis as regular, full-time employees of Employer and their eligible dependents during the period that Employee is receiving Base Salary payments under Section&nbsp;5 of this
Agreement and, in all cases, as provided by any applicable law. Following such period of continued benefit plan coverage, Employee and each of his eligible dependents shall be entitled to elect for continuation of coverage provided pursuant to
Section&nbsp;601 et. seq. of the Employee Retirement Income Security Act of 1974, 29 USC &#167;1101 (&#147;COBRA&#148;). </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.10&nbsp;&nbsp;&nbsp;&nbsp;<I>Period for Exercising Stock Options After Termination. </I>Except as to incentive stock options granted in
accordance with Section&nbsp;422 of the Internal Revenue Code, after termination of Employee&#146;s employment under this Agreement for any reason other than pursuant to Section&nbsp;4.1, Employee shall be allowed a period of one hundred eighty
(180)&nbsp;days during which to exercise any vested options to purchase MEDNAX, Inc.&#146;s common stock or vested stock appreciation rights and realize any other vested Equity Awards that may be granted or made under any Equity Plan; provided,
however, that in no event shall the period during which Employee may exercise any vested stock option or vested stock appreciation right be extended pursuant to this Section&nbsp;5.10 to a date that is later than the earlier of (i)&nbsp;the latest
date upon which the stock right </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">8 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px;padding-bottom:0px; "><FONT STYLE="font-family:Times New Roman" SIZE="2">
could have expired by its original terms under any circumstances or (ii)&nbsp;the tenth (10</FONT><FONT STYLE="font-family:Times New Roman" SIZE="1"><SUP
STYLE="vertical-align:baseline; position:relative; bottom:.8ex">th</SUP></FONT><FONT STYLE="font-family:Times New Roman" SIZE="2">) anniversary of the original date of grant of the stock right. In all other respects, the terms of the applicable
Equity Plan shall control the terms and conditions of any Equity Awards. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.11.&nbsp;&nbsp;&nbsp;&nbsp;<I>Performance Bonus.
</I>In the situations described in Sections 5.2, 5.3, 5.4, 5.5 and 5.7, upon termination of this Agreement, Employee<B> </B>will be paid, solely in consideration of services rendered by Employee prior to termination, a bonus with respect to
Employer&#146;s fiscal year in which the termination date occurs, equal to the Performance Bonus, if any, that would have been payable to Employee, based on Employee and Employer meeting certain goals and objectives, for the fiscal year if
Employee&#146;s employment had not been terminated, multiplied by the number of days in the fiscal year prior to and including the date of termination and divided by three hundred sixty five (365). The amount of the Post-Termination Performance
Bonus paid in the situations described in Sections 5.2, 5.3, 5.4 5.5 and 5.7 shall be determined in good faith by Employer in its sole discretion at the time that Employer distributes bonuses to similarly situated employees. Any amount payable under
this Section&nbsp;5.11 shall be paid to Employee when Employer pays performance bonuses to its eligible employees, which shall be in the calendar year following the termination date of this Agreement. In addition, in the situations described in
Section&nbsp;5.7, Employee will be paid, solely in consideration of services rendered by Employee prior to termination, an additional bonus with respect to Employer&#146;s fiscal year in which the termination date occurs, equal to the greater of
Employee&#146;s Average Annual Performance Bonus (as defined in Section&nbsp;5.4) or Employee&#146;s bonus for the year immediately preceding Employee&#146;s termination. Such additional bonus shall be payable to Employee within ninety
(90)&nbsp;days of Employee&#146;s termination date pursuant to Section&nbsp;4.7. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.12.&nbsp;&nbsp;&nbsp;&nbsp;<I>Section</I>
<I>409A Compliance</I>. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a)&nbsp;&nbsp;&nbsp;&nbsp;General.<B> </B>It is the intention of both Employer and
Employee that the benefits and rights to which Employee could be entitled in connection with termination of employment comply with Section&nbsp;409A of the Code and the Treasury Regulations and other guidance promulgated or issued thereunder
(&#147;Section&nbsp;409A&#148;), and the provisions of this Agreement shall be construed in a manner consistent with that intention. If Employee or Employer believes, at any time, that any such benefit or right does not so comply, it shall promptly
advise the other and shall negotiate reasonably and in good faith to amend the terms of such benefits and rights such that they comply with Section&nbsp;409A of the Code (with the most limited possible economic effect on Employee and on Employer).
</FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(b)&nbsp;&nbsp;&nbsp;&nbsp;Distributions on Account of Separation from Service.<B> </B>If and to the extent
required to comply with Section&nbsp;409A, no payment or benefit required to be paid under this Agreement on account of termination of Employee&#146;s employment shall be made unless and until Employee incurs a &#147;separation from service&#148;,
within the meaning of Section&nbsp;409A. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(c)&nbsp;&nbsp;&nbsp;&nbsp;6 Month Delay for Specified Employees. </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(i)&nbsp;&nbsp;&nbsp;&nbsp;If Employee is a &#147;specified employee&#148;, then no payment or benefit that is payable on account of
Employee&#146;s &#147;separation from service&#148;, as that term is defined for purposes of Section&nbsp;409A, shall be made before the date that is six months after Employee&#146;s &#147;separation from service&#148; (or, if earlier, the date of
Employee&#146;s death) if </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">9 </FONT></P>


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and to the extent that such payment or benefit constitutes deferred compensation (or may be nonqualified deferred compensation) under Section&nbsp;409A and such deferral is required to comply
with the requirements of Section&nbsp;409A. Any payment or benefit delayed by reason of the prior sentence shall be paid out or provided in a single lump sum at the end of such required delay period in order to catch up to the original payment
schedule. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(ii)&nbsp;&nbsp;&nbsp;&nbsp;For purposes of this provision, Employee shall be considered to be a
&#147;specified employee&#148; if, at the time of his or her separation from service, Employee is a &#147;key employee&#148;, within the meaning of Section&nbsp;416(i) of the Code, of Employer (or any person or entity with whom Employer would be
considered a single employer under Section&nbsp;414(b) or Section&nbsp;414(c) of the Code) any stock in which is publicly traded on an established securities market or otherwise. </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(iii)&nbsp;&nbsp;&nbsp;&nbsp;Unless otherwise required to comply with Section&nbsp;409A, a payment or benefit shall not be
deferred pursuant to this provision if: </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:13%; text-indent:4%;padding-bottom:0px; "><FONT STYLE="font-family:Times New Roman" SIZE="2">(x)&nbsp;&nbsp;&nbsp;&nbsp;it is not made on
account of Employee&#146;s &#147;separation from service&#148;, (y) it is required to be paid no later than within 2<FONT SIZE="1"><SUP STYLE="vertical-align:baseline; position:relative; bottom:.8ex">&nbsp;1</SUP></FONT><FONT SIZE="2">/</FONT><FONT
SIZE="1"><SUB STYLE="vertical-align:baseline; position:relative; top:.1ex">2</SUB></FONT><FONT STYLE="font-family:Times New Roman" SIZE="2"> months after the end of the taxable year of Employee in which the payment or benefit is no longer subject to
a &#147;substantial risk of forfeiture&#148;, as that term is defined for purposes of Section&nbsp;409A, or (z)&nbsp;the payment satisfies the following requirements: (A)&nbsp;it is being paid or provided due to Employer&#146;s termination of
Employee&#146;s employment without Cause (Section 4.4) or Employee&#146;s termination of employment after a Change in Control for the reasons set forth in Section&nbsp;4.7 hereof, (B)&nbsp;it does not exceed two times the lesser of
(1)&nbsp;Employee&#146;s annualized compensation from Employer for the calendar year prior to the calendar year in which the termination of Employee&#146;s employment occurs, and (2)&nbsp;the maximum amount of compensation that may be taken into
account under a qualified plan pursuant to Section&nbsp;401(a)(17) of the Code for the year in which Employee&#146;s employment terminates, and (C)&nbsp;the payment is required under this Agreement to be paid no later than the last day of the second
calendar year following the calendar year in which Employee incurs a &#147;separation from service&#148;. </FONT></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(d)&nbsp;&nbsp;&nbsp;&nbsp;No Acceleration of Payments. Neither Employer nor Employee, individually or in combination, may
accelerate any payment or benefit that is subject to Section&nbsp;409A, except in compliance with Section&nbsp;409A and the provisions of this Agreement, and no amount shall be paid prior to the earliest date on which it may be paid without
violating Section&nbsp;409A. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(e)&nbsp;&nbsp;&nbsp;&nbsp;Treatment of Each Installment as a Separate Payment.
For purposes of applying the provisions of Section&nbsp;409A to this Agreement, each separately identified amount to which Employee is entitled under this Agreement shall be treated as a separate payment. In addition, to the extent permissible under
Section&nbsp;409A, any series of installment payments under this Agreement shall be treated as a right to a series of separate payments. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">10 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(f)&nbsp;&nbsp;&nbsp;&nbsp;Reimbursements and
<FONT STYLE="white-space:nowrap">In-Kind</FONT> Benefits. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(i)&nbsp;&nbsp;&nbsp;&nbsp;Any reimbursements by
Employer to Employee of any eligible expenses pursuant to Section&nbsp;3.1 or 5.8 of this Agreement, that are not excludible from Employee&#146;s income for Federal income tax purposes (&#147;Taxable Reimbursements&#148;) shall be made on or before
the last day of the taxable year of Employee following the year in which the expense was incurred. </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(ii)&nbsp;&nbsp;&nbsp;&nbsp;The amount of any Taxable Reimbursements, and the value of any
<FONT STYLE="white-space:nowrap">in-kind</FONT> benefits to be provided to Employee under this Agreement, during any taxable year of Employee shall not affect the expenses eligible for reimbursement, or
<FONT STYLE="white-space:nowrap">in-kind</FONT> benefits to be provided, in any other taxable year of Employee. </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(iii)&nbsp;&nbsp;&nbsp;&nbsp;The right to Taxable Reimbursements, or <FONT STYLE="white-space:nowrap">in-kind</FONT>
benefits, shall not be subject to liquidation or exchange for another benefit. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.13.&nbsp;&nbsp;&nbsp;&nbsp;<I>Release.
</I>Employer shall provide Employee with a general release in the form attached as Exhibit C (subject to such modifications as Employer may reasonably request) within seven (7)&nbsp;days after Employee&#146;s termination date.&nbsp;Payments or
benefits to which Employee may be entitled pursuant to this Section&nbsp;5 (other than any accrued but unpaid Base Salary and employee benefits as of the end of the Employment Period) (the &#147;Severance Amounts&#148;) shall be conditioned upon
Employee executing the general release within 21 days after receiving it from Employer and the general release becoming irrevocable upon the expiration of 7 days following the Employee&#146;s execution of it. Payment of the Severance Amounts shall
be suspended during the period (the &#147;Suspension Period&#148;) that begins on Employee&#146;s termination date and ends on the date (&#147;Suspension Termination Date&#148;) that is thirty-five (35)&nbsp;days after Employee&#146;s termination
date; provided, however, that this suspension shall not apply, and Employer shall be required to provide, any continued health insurance coverage that would be required under Section&nbsp;5.9 hereof during the Suspension Period. If Employee executes
the general release and the general release becomes irrevocable by no later than the Suspension Termination Date, then payment of any Severance Amounts that were suspended pursuant to this provision shall be made in the first payroll period that
follows the Suspension Termination Date, and any Severance Amounts that are payable after the Suspension Termination Date shall be paid at the times provided in Section&nbsp;5. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.14.&nbsp;&nbsp;&nbsp;&nbsp;<I>Vesting of Incentive Awards. </I>Notwithstanding any contrary provision in this Agreement or<B> </B>any
Equity Plan then maintained by MEDNAX, Inc.: </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a) all Equity Awards granted to Employee by MEDNAX, Inc. prior to termination
of this Agreement shall continue to vest until fully vested following a termination of Employee&#146;s employment pursuant to Section&nbsp;4.2, 4.3, and 4.5;<B> </B>and </FONT></P>
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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(b) in the event of a Change in Control after the date of this Agreement: </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(i)&nbsp;&nbsp;&nbsp;&nbsp;if, prior to the one (1)&nbsp;year anniversary of the effective date of such Change in Control,
the employment by MEDNAX, Inc. or its affiliates or successors of both Roger J. Medel, M.D. and Joseph M. Calabro is terminated for any reason, or they both no longer hold the positions they held just prior to the Change in Control (and neither
holds the top executive position in the company), then the Equity Awards granted to the Employee that are outstanding (the &#147;Accelerated Awards&#148;) shall become fully vested and payable to the Employee on the first anniversary of the
effective date of such Change in Control; provided, however, that any portion of the Accelerated Awards that is scheduled to become vested and payable pursuant to its terms prior to the first anniversary of such Change in Control shall become vested
and payable to the Employee pursuant to its terms; and </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(ii) &nbsp;&nbsp;&nbsp;&nbsp;if, after the one
(1)&nbsp;year anniversary of the effective date of such Change in Control, the employment by MEDNAX, Inc. or its affiliates or successors of both Roger J. Medel, M.D. and Joseph M. Calabro is terminated for any reason, or they both no longer hold
the positions they held just prior to the Change in Control (provided that neither holds the top executive position in the company), then the Accelerated Awards shall become fully vested and payable to the Employee on the one (1)&nbsp;year
anniversary of the termination date, or date of the change in position of Roger J. Medel, M.D. or Joseph M. Calabro, whichever termination date or date in change of position is later; provided, however, that any portion of the Accelerated Awards
that is scheduled to become vested and payable pursuant to its terms prior to the one (1)&nbsp;year anniversary of such termination date or date of change in position shall become vested and payable to the Employee pursuant to its terms; </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">provided in the case of both clauses (i)&nbsp;and (ii) above, that the Employee remains in Continuous Service (as defined in the applicable Equity Plan)
from the date of this Agreement through the date on which such Accelerated Awards would vest pursuant to clauses (i)&nbsp;or (ii) above, as applicable. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(iii)&nbsp;&nbsp;&nbsp;&nbsp;if at any time after a Change in Control after the date of this Agreement, Employee&#146;s employment is terminated pursuant to Section&nbsp;4.4 or 4.7(a),(b)(d)(e) or (f),
then all of the Accelerated Awards will be fully vested and exercisable as of the effective date of such termination. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Notwithstanding anything to the contrary in this Agreement, the Equity Plans or the Equity Awards, in the event of a Change in Control
immediately following which neither the common stock of MEDNAX, Inc. nor the common equity of its successor, parent or subsidiary is listed for trading on a national securities exchange (a &#147;Going Private Transaction&#148;), then all unvested
Equity Awards granted to the Employee shall be adjusted so that in lieu of the Employee&#146;s right to receive shares of common stock of MEDNAX, Inc. pursuant to the terms of such Equity Awards, the Employee shall be entitled to receive, for each
share of common stock of MEDNAX, Inc. that Employee would otherwise be entitled to receive pursuant to such Equity Awards, an amount of cash equal to the amount per share of common stock of MEDNAX, Inc. paid to the shareholders of MEDNAX, Inc. in
such Going Private Transaction, as determined by the Compensation Committee of the Board in its sole discretion, in each case consistent with the vesting schedule of such Equity Awards and shall remain subject to the acceleration provisions set
forth in this Section&nbsp;5.14. </FONT></P>
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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>6.&nbsp;&nbsp;&nbsp;&nbsp;Successors; Binding Agreement. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">6.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Successors</I>. Employer shall require any successor (whether direct or indirect, by purchase, merger,
consolidation or otherwise) acquiring a majority of Employer&#146;s voting common stock or any other successor to all or substantially all of the business and/or assets of Employer to expressly assume and agree to perform this Agreement in the same
manner and to the same extent that Employer would be required to perform it if no such succession had taken place and Employee hereby consents to any such assignment. In such event, &#147;Employer&#148; shall mean Employer as previously defined and
any successor to its business and/or assets which executes and delivers the agreement provided for in this Section&nbsp;6 or which otherwise becomes bound by all the terms and provisions of this Agreement by operation of law. This Section shall not
limit Employee&#146;s ability to terminate this Agreement in the circumstances described in Section&nbsp;4.7 in the event of a Change in Control. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">6.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>Benefit</I>. This Agreement and all rights of Employee under this Agreement shall inure to the benefit of and be enforceable by Employee&#146;s personal or legal
representatives, executors, administrators, successors, heirs, distributees, devisees and legatees. If Employee should die after the termination date and amounts would have been payable to Employee under this Agreement if Employee had continued to
live, including under Section&nbsp;5 hereof, then such amounts shall be paid to Employee&#146;s devisee, legatee, or other designee or, if there is no such designee, Employee&#146;s estate. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>7.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Conflicts with Prior Employment Contract. </B>Except as otherwise provided in this Agreement with
respect to the May&nbsp;9, 2018 expiration of the Prior Employment Agreement, this Agreement constitutes the entire agreement among the parties pertaining to the subject matter hereof, and supersedes and revokes any and all prior or existing
agreements, written or oral, relating to the subject matter hereof, and this Agreement shall be solely determinative of the subject matter hereof. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>8.&nbsp;&nbsp;&nbsp;&nbsp;Restrictive Covenants; Confidential Information; Work Product; Injunctive Relief. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">8.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>No Material Competition</I>. Employer and Employee acknowledge and agree that a strong relationship and connection exists between Employer and its current and prospective
patients, referral sources, and customers as well as the hospitals and healthcare facilities at which it provides professional services. Employer and Employee further acknowledge and agree that the restrictive covenants described in this Section are
designed to enforce, and are ancillary to or part of, the promises contained in this Agreement and are reasonably necessary to protect the legitimate interests of Employer in the following: (1)&nbsp;the use and disclosure of the Confidential
Information as described in Section&nbsp;8.4; (2) the professional development activities described in Section&nbsp;1.2; and (3)&nbsp;the goodwill of the Employer, as promoted by Employee as provided in Section&nbsp;1.2. The foregoing listing is by
way of example only and shall not be construed to be an exclusive or exhaustive list of such interests. Employee acknowledges that the restrictive covenants set forth below are of significant value to Employer and were a material inducement to
Employer in agreeing to the terms of this Agreement. Employee further acknowledges that the goodwill and other proprietary interest of Employer will suffer irreparable and continuing damage in the event Employee enters into competition with Employer
in violation of this Section. </FONT></P>
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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Therefore, Employee agrees that, except with respect to services performed under this
Agreement on behalf of Employer, <B>Employee shall not</B>, at any time during the Restricted Period (as defined below), for Employee or on behalf of any other person, persons, firm, partnership, corporation or employer, participate or engage in or
own an interest in, directly or indirectly, any individual proprietorship, partnership, corporation, joint venture, trust or other form of business entity, whether as an individual proprietor, partner, joint venturer, officer, director, member,
employee, consultant, independent contractor, stockholder, lender, landlord, finder, agent, broker, trustee, or in any manner whatsoever, if such entity or its affiliates is engaged in, directly or indirectly, &#147;Employer&#146;s Business,&#148;
as defined on Exhibit A hereto. Employee acknowledges that, as of the date hereof, Employee&#146;s responsibilities will include matters affecting the businesses of Employer listed on Exhibit A. For purposes of this Section&nbsp;8, the
&#147;Restricted Period&#148; shall mean the Employment Period plus (i)&nbsp;eighteen (18) months in the event this Agreement is terminated pursuant to Sections 4.1, 4.7(a), 4.7(b), 4.7(d), 4.7(e), or 4.7(f) or (ii)&nbsp;twenty-four (24)&nbsp;months
in the event the Agreement is terminated for any other reason. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>No Hire</I>. Employee further
agrees that <B>Employee shall not</B>, at any time during the Employment Period and for a period of eighteen (18)&nbsp;months immediately following termination of this Agreement for any reason, for Employee or on behalf of any other person, persons,
firm, partnership, corporation or employer, employ, or knowingly permit any company or business directly or indirectly controlled by Employee to employ or otherwise engage (a)&nbsp;any person who is a then current employee or independent contractor
of Employer or one of its affiliates, or (b)&nbsp;any person who was an employee or independent contractor of Employer or one of its affiliates in the prior six (6)&nbsp;month period, or in any manner seek to induce such persons to leave his or her
employment or engagement with Employer or one of its affiliates (including without limitation for or on behalf of a subsequent employer of Employee). </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">8.3&nbsp;&nbsp;&nbsp;&nbsp;<I><FONT STYLE="white-space:nowrap">Non-solicitation.</FONT> </I>Employee further agrees that <B>Employee shall not</B>, at any time during the Employment Period and for a
period of eighteen (18)&nbsp;months immediately following termination of this Agreement for any reason, for Employee or on behalf of any other person, persons, firm, partnership, corporation or employer, solicit or accept business from or take any
action that would interfere with, diminish or impair the valuable relationships that Employer or its affiliates have with (i)&nbsp;hospitals or other health care facilities with which Employer or its affiliates have contracts to render professional
services or otherwise have established relationships, (ii)&nbsp;patients, (iii) referral sources, (iv)&nbsp;vendors, (v) any other clients of Employer or its affiliates, or (vi)&nbsp;prospective hospitals, patients, referral sources, vendors or
clients whose business Employee was aware that Employer or any affiliate of Employer was in the process of soliciting at the time of Employee&#146;s termination (including potential acquisition targets). </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.4.&nbsp;&nbsp;&nbsp;&nbsp;<I>Confidential Information</I>. At all times during the term of this Agreement, Employer shall provide
Employee with access to &#147;Confidential Information.&#148; As used in this Agreement, the term &#147;Confidential Information&#148; means any and all confidential, proprietary or trade secret information, whether disclosed, directly or
indirectly, verbally, in writing or by any other means in tangible or intangible form, including that which is conceived or developed by Employee, applicable to or in any way related to: (i)&nbsp;patients with whom Employer has a physician/patient
relationship; (ii)&nbsp;the present or future business of Employer; or (iii)&nbsp;the research and development of </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">14 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
Employer. Without limiting the generality of the foregoing, Confidential Information includes: (a)&nbsp;the development and operation of Employer&#146;s medical practices, including information
relating to budgeting, staffing needs, marketing, research, hospital relationships, equipment capabilities, and other information concerning such facilities and operations and specifically including the procedures and business plans developed by
Employer for use at the hospitals where Employer conducts its business; (b)&nbsp;contractual arrangements between the Employer and insurers or managed care associations or other payors; (c)&nbsp;the databases of Employer; (d)&nbsp;the clinical and
research protocols of Employer, including coding guidelines; (e)&nbsp;the referral sources of Employer; (f)&nbsp;other confidential information of Employer that is not generally known to the public that gives Employer the opportunity to obtain an
advantage over competitors who do not know or use it, including the names, addresses, telephone numbers or special needs of any of its patients, its patient lists, its marketing methods and related data, lists or other written records used in
Employer&#146;s business, compensation paid to employees and other terms of employment, accounting ledgers and financial statements, contracts and licenses, business systems, business plan and projections, and computer programs. The parties agree
that, as between them, this Confidential Information constitutes important, material, and confidential trade secrets that affect the successful conduct of Employer&#146;s business and its goodwill. Employer acknowledges that the Confidential
Information specifically enumerated above is special and unique information and is not information that would be considered a part of the general knowledge and skill Employee has or might otherwise obtain. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Notwithstanding the foregoing, Confidential Information shall not include any information that (i)&nbsp;was known by Employee from a
third party source before disclosure by or on behalf of Employer, (ii)&nbsp;becomes available to Employee from a source other than Employer that is not, to Employee&#146;s knowledge, bound by a duty of confidentiality to Employer, (iii)&nbsp;becomes
generally available or known in the industry other than as a result of its disclosure by Employee, or (iv)&nbsp;has been independently developed by Employee and may be disclosed by Employee without breach of this Agreement, provided, in each case,
that the Employee shall bear the burden of demonstrating that the information falls under one of the above-described exceptions. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Employee agrees that the terms of this Agreement shall be deemed Confidential Information for purposes of this Section. Employee shall keep the terms of this Agreement strictly confidential and will not,
without the prior written consent of Employer, disclose the details of this Agreement to any third party in any manner whatsoever in whole or in part, with the exception of Employee&#146;s representatives (such as tax advisors and attorneys) who
need to know such information. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Employee agrees that Employee will not at any time, whether during or subsequent to the term
of Employee&#146;s employment with Employer, in any fashion, form or manner, unless specifically consented to in writing by Employer, either directly or indirectly, use or divulge, disclose, or communicate to any person, firm or corporation, in any
manner whatsoever, any Confidential Information of any kind, nature, or description, subject to applicable law. The parties agree that any breach by Employee of any term of this Section is a material breach of this Agreement and shall constitute
&#147;cause&#148; for the termination of Employee&#146;s employment hereunder. In the event that Employee is ordered to disclose any Confidential Information, whether in a legal or a regulatory proceeding or otherwise, Employee shall provide
Employer with prompt written notice of such request or order so that Employer may seek to prevent disclosure or, if that cannot be achieved, the entry of a protective order or other appropriate protective device or procedure in order to assure, to
</FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">15 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
the extent practicable, compliance with the provisions of this Agreement. In the case of any disclosure required by law, Employee shall disclose only that portion of the Confidential Information
that Employee is ordered to disclose in a legally binding subpoena, demand or similar order issued pursuant to a legal or regulatory proceeding. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">All Confidential Information, and all equipment, notebooks, documents, memoranda, reports, files, samples, books, correspondence, lists, other written and graphic records, in any media (including
electronic or video) containing Confidential Information or relating to the business of Employer, which Employee shall prepare, use, construct, observe, possess, or control shall be and remain Employer&#146;s sole property (collectively
&#147;Employer Property&#148;). Upon termination or expiration of this Agreement, or earlier upon Employer&#146;s request, Employee shall promptly deliver to Employer all Employer Property, retaining none. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.5.&nbsp;&nbsp;&nbsp;&nbsp;<I>Ownership of Work Product.</I> Employee agrees and acknowledges that (i)&nbsp;all copyrights, patents,
trade secrets, trademarks, service marks, or other intellectual property or proprietary rights associated with any ideas, concepts, techniques, inventions, processes, or works of authorship developed or created by Employee during the course of
performing work for Employer and any other work product conceived, created, designed, developed or contributed by Employee during the term of this Agreement that relates in any way to Employer&#146;s Business (collectively, the &#147;Work
Product&#148;), shall belong exclusively to Employer and shall, to the extent possible, be considered a work made for hire within the meaning of Title 17 of the United States Code. To the extent the Work Product may not be considered a work made for
hire owned exclusively by Employer, Employee hereby assigns to Employer all right, title, and interest worldwide in and to such Work Product at the time of its creation, without any requirement of further consideration. Upon request of Employer,
Employee shall take such further actions and execute such further documents as Employer may deem necessary or desirable to further the purposes of this Agreement, including without limitation separate assignments of all right, title, and interest in
and to all rights of copyright and all right, title, and interest in and to any inventions or patents and any reissues or extensions which may be granted therefore, and in and to any improvements, additions to, or modifications thereto, which
Employee may acquire by invention or otherwise, the same to be held and enjoyed by Employer for its own use and benefit, and for the use and benefit of Employer&#146;s successors and assigns, as fully and as entirely as the same might be held by
Employee had this assignment not been made. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.6.&nbsp;&nbsp;&nbsp;&nbsp;<I>Clearance Procedure for Proprietary Rights Not
Claimed by Employer.</I> In the event that Employee wishes to create or develop, <I>other than</I> on Employer&#146;s time or using Employer&#146;s resources, anything that may be considered Work Product but to which Employee believes Employee
should be entitled to the personal benefit of, Employee agrees to follow the clearance procedure set forth in this Section. Before beginning any such work, Employee agrees to give Employer advance written notice and provide Employer with a
sufficiently detailed written description of the work under consideration for Employer to make a determination regarding the work. Unless otherwise agreed in a writing signed by Employer prior to receipt, Employer shall have no obligation of
confidentiality with respect to such request or description. Employer will determine in its sole discretion, within thirty (30)&nbsp;days after Employee has fully disclosed such plans to Employer, whether rights in such work will be claimed by
Employer. If Employer determines that it does not claim rights in such work, Employer agrees to so notify Employee in writing and </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">16 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
Employee may retain ownership of the work to the extent that such work has been expressly disclosed to Employer. If Employer fails to so notify Employee within such thirty (30)&nbsp;day period,
then Employer shall be deemed to have agreed that such work is not considered Work Product for purposes of this Agreement. Employee agrees to submit for further review any significant improvement, modification, or adaptation that could reasonably be
related to Employer&#146;s Business so that it can be determined whether the improvement, modification, or adaptation relates to the business or interests of Employer. Clearance under this procedure does not relieve Employee of the restrictive
covenants set forth in this Section&nbsp;8. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.7.&nbsp;&nbsp;&nbsp;&nbsp;<I><FONT STYLE="white-space:nowrap">Non-Disparagement.</FONT></I> For a period of ten (10)&nbsp;years after
the termination of this Agreement, Employee will not, directly or indirectly, as an individual or on behalf of a firm, corporation, partnership or other legal entity, make any disparaging or negative comment to any other person or entity regarding
Employer or any of its affiliates, agents, attorneys, employees, officers and directors, Employee&#146;s work conditions or circumstances surrounding Employee&#146;s separation from Employer or otherwise impugn or criticize the name or reputation of
Employer, its affiliates, agents, attorneys, employees, officers or directors, orally or in writing. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.8.&nbsp;&nbsp;&nbsp;&nbsp;<I>Review by Employee.</I> <B>Employee has carefully read and considered the terms and provisions of this
Section</B><B></B><B>&nbsp;8, and having done so, agrees that the restrictions set forth in this Section</B><B></B><B>&nbsp;8 are fair and reasonably required for the protection of the interests of Employer.</B> In the event that any term or
provision set forth in this Section&nbsp;8 shall be held to be invalid or unenforceable by a court of competent jurisdiction, the parties hereto agree that such invalid or unenforceable term(s) or provision(s) may be severed from this Agreement
without, in any manner, affecting the remaining portions hereof. Without limiting other possible remedies available to Employer, Employee agrees that injunctive or other equitable relief will be available to enforce the covenants set forth in this
Section, such relief to be without the necessity of posting a bond. In the event that, notwithstanding the foregoing, any part of the covenants set forth in this Section shall be held to be invalid, overbroad, or unenforceable by an arbitration
panel or a court of competent jurisdiction, the parties hereto agree that such invalid, overbroad, or unenforceable provision(s) may be modified or severed from this Agreement without, in any manner, affecting the remaining portions of this
Section&nbsp;8 (all of which shall remain in full force and effect). In the event that any provision of this Section&nbsp;8 related to time period or areas of restriction shall be declared by an arbitration panel or a court of competent jurisdiction
to exceed the maximum time period, area or activities such arbitration panel or court deems reasonable and enforceable, said time period or areas of restriction shall be deemed modified to the minimum extent necessary to make the geographic or
temporal restrictions or activities reasonable and enforceable. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.9.&nbsp;&nbsp;&nbsp;&nbsp;<I>Survival.</I> The provisions
of this Section&nbsp;8 shall survive the termination of this Agreement and Employee&#146;s employment with Employer.<B> </B>The provisions of this Section&nbsp;8 shall apply during the time Employee is receiving Disability payments from Employer as
a result of a termination of this Agreement pursuant to Section&nbsp;4.2 hereof.<B> </B>In the event of a breach of this Section&nbsp;8 by Employee, Employer retains the right to terminate any continuing payments to Employee provided for in
Section&nbsp;5 of this Agreement. The provisions of this Section&nbsp;8 are expressly intended to benefit and be enforceable by other affiliated entities of Employer, who are express third party beneficiaries hereof. Employee shall not assist others
in engaging in any of the activities described in the foregoing restrictive covenants. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">17 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>9.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Arbitration. </B>Any controversy or claim arising out of
or relating to this Agreement, or any alleged breach hereof shall be finally determined by binding arbitration before a three member panel, consisting of one member selected by each party hereto, with the third member selected by the first two
arbitrators. Each party hereto shall bear the costs of its own nominee, and shall share equally the cost of the third arbitrator and the parties agree that the costs of arbitration shall not be subject to reapportionment by the arbitration panel.
The arbitration proceedings shall be held in Sunrise, Florida, unless otherwise mutually agreed by the parties, and shall be conducted in accordance with the American Arbitration Association National Rules for the Resolution of Employment Disputes
then in effect. Judgment on the award rendered by the arbitration panel may be entered and enforced by any court having jurisdiction thereof. Notwithstanding anything herein to the contrary, if the Employer shall require immediate injunctive relief,
then the Employer shall be entitled to seek such relief in any court having jurisdiction, and if the Employer elects to do so, the Employee hereby consents to the jurisdiction of the state and federal courts sitting in the State of Florida and to
the applicable service of process. Employee hereby waives and agrees not to assert, to the fullest extent permitted by applicable law, any claim that (i)&nbsp;Employee is not subject to the jurisdiction of such courts, (ii)&nbsp;Employee is immune
from any legal process issued by such courts and (iii)&nbsp;any litigation or other proceeding commenced in such courts is brought in an inconvenient forum. Any such arbitration shall be treated as confidential by all parties thereto, except as
otherwise provided by law or as otherwise necessary to enforce any judgment or order issued by the arbitrators. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>10.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Governing Law.</B> This Agreement shall be governed by and construed in accordance with the laws of
the State of Florida without regard to its conflict of laws principles to the extent that such principles would require the application of laws other than the laws of the State of Florida. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>11.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Notices.</B> Any notice required or permitted to be given under this Agreement shall be in writing
and shall be deemed to have been given when delivered by hand or when deposited in the United States mail by registered or certified mail, return receipt requested, postage prepaid, addressed as follows: </FONT></P>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
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<TR>
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<TD WIDTH="47%"></TD></TR>


<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">If to Employer:</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">If to Employee:</FONT></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Mednax Services, Inc.</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Dominic J. Andreano</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">1301 Concord Terrace</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">c/o Mednax Services, Inc.</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Sunrise, FL 33323</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">1301 Concord Terrace</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Attention: General Counsel</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Sunrise, FL 33323</FONT></TD></TR>
</TABLE> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">or to such other addresses as either party hereto may from time to time give notice of to the other in the aforesaid
manner. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>12.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Benefits: Binding Effect.</B> This Agreement shall be for the benefit of and
binding upon the parties hereto and their respective heirs, personal representatives, legal representatives, successors and, where applicable, assigns. Notwithstanding the foregoing, Employee may not assign the rights or benefits hereunder without
the prior written consent of Employer. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">18 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>13.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Severability. </B>The invalidity of any one or more of
the words, phrases, sentences, clauses or sections contained in this Agreement shall not affect the enforceability of the remaining portions of this Agreement or any part thereof, all of which are inserted conditionally on their being valid in law,
and, in the event that any one or more of the words, phrases, sentences, clauses or sections contained in this Agreement shall be declared invalid, this Agreement shall be construed as if such invalid word or words, phrase or phrases, sentence or
sentences, clause or clauses, or section or sections had not been inserted. If such invalidity is caused by length of time or size of area, or both, the otherwise invalid provision will be considered to be reduced to a period or area, which would
cure such invalidity. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>14.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Waivers. </B>The waiver by either party hereto of a breach or
violation of any term or provision of this Agreement shall not operate nor be construed as a waiver of any subsequent breach or violation. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>15.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Damages. </B>Nothing contained herein shall be construed to prevent Employer or Employee from seeking and recovering from the other damages sustained by either or both
of them as a result of a breach of any term or provision of this Agreement. In the event that either party hereto brings suit for the collection of any damages resulting from, or the injunction of any action constituting, a breach of any of the
terms or provisions of this Agreement, then the party found to be at fault shall pay all reasonable court costs and attorneys&#146; fees of the other, whether such costs and fees are incurred in a court of original jurisdiction or one or more courts
of appellate jurisdiction. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>16.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>No Third Party Beneficiary. </B>Except as provided in
Section&nbsp;8.9, nothing expressed or implied in this Agreement is intended, or shall be construed, to confer upon or give any person (other than the parties hereto and, in the case of Employee, Employee&#146;s heirs, personal representative(s)
and/or legal representative) any rights or remedies under or by reason of this Agreement. No agreements or representations, oral or otherwise, express or implied, have been made by either party with respect to the subject matter of this Agreement
which agreements or representations are not set forth expressly in this Agreement, and this Agreement supersedes any other employment agreement between Employer and Employee. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>17.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Assignment.</B> This Agreement may be assigned by Employer upon notice to Employee. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><I>The remainder of this page has been left blank intentionally. </I></FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">19 </FONT></P>



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 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>IN WITNESS WHEREOF</B>, the undersigned have executed this Agreement this 12th day of
February, 2018, effective as of the Effective Date. </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD WIDTH="2%"></TD>
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<TD WIDTH="44%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
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<TD VALIGN="bottom"></TD>
<TD WIDTH="2%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="44%"></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>EMPLOYER:</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3"><B>EMPLOYEE:</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>MEDNAX SERVICES, INC.</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">By:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Manuel Kadre</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">By:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Dominic J. Andreano</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Manuel Kadre</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Chairman, Compensation Committee</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD></TR>
</TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">20 </P>


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 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>EXHIBIT A </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>BUSINESS OF EMPLOYER </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">As of the date hereof, Employer, directly or through
its affiliates, provides professional medical services and all aspects of practice management services in medical practice areas that include, but are not limited to, the following (collectively referred to herein as &#147;Employer&#146;s
Business&#148;): </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(1) Neonatology, including hospital well baby care; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(2) Maternal-Fetal Medicine, including general obstetrics services; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(3) Pediatric Cardiology;
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(4) Pediatric Intensive Care, including Pediatric Hospitalist Care; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(5) Newborn hearing screening services; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(6) Pediatric Surgery; </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(7) Pediatric Emergency Medicine; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(8)
Anesthesiology, critical care medicine and pain management; and </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(9) Radiology and Teleradiology. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">References to Employer&#146;s Business in this Agreement shall include such other medical service lines, practice management services and
other businesses in which Employer is engaged during the Employment Period; <I>provided,</I> that to be considered a part of Employer&#146;s Business, Employer must have engaged in such other service line, practice management service or other
business at least six (6)&nbsp;months prior to the termination date of this Agreement. For purposes of this Exhibit A, businesses of Employer shall include the businesses conducted by Employer&#146;s subsidiaries, entities under common control and
affiliates as defined under Rule 144 of the Securities Act of 1933, as amended. Such affiliates shall include the professional corporations and associations whose operating results are consolidated with Employer for financial reporting purposes.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Notwithstanding the foregoing, Employer acknowledges and agrees to the following exceptions and clarifications regarding the
scope of Employer&#146;s Business. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">A.&nbsp;&nbsp;&nbsp;&nbsp;<I>Hospital Services. </I>Employer and Employee acknowledge
that, as of the date hereof, Employer does not currently operate hospitals, hospital systems or universities. Nevertheless, the businesses of hospitals, hospital systems and universities would be the same as Employer&#146;s Business where such
hospitals, hospital systems or universities provide or contract with others to provide some or all of the medical services included in Employer&#146;s Business. Therefore, the parties desire to clarify their intent with respect to the limitations on
Employee&#146;s ability to work for or contract with others to provide services for a hospital, hospital system or university during the Employment Period and during the Restricted Period. Section&nbsp;8.1 shall not be deemed to restrict
Employee&#146;s ability to work for a hospital, hospital system or university if the hospital, hospital system or university does not provide any of the medical services included in Employer&#146;s Business. Furthermore, even if a hospital, hospital
system or university provides medical services that are included in Employer&#146;s Business, Employee may work for such hospital, hospital system or university if Employee has no direct supervisory responsibility for or involvement in the
hospital&#146;s, </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">21 </FONT></P>



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hospital system&#146;s or university&#146;s medical services that are Employer&#146;s Business. Finally, Employer agrees that Employee may hold direct supervisory responsibility for or be
involved in the medical services of a hospital, hospital system or university that are included in Employer&#146;s Business so long as such hospital, hospital system or university is located at least ten (10)&nbsp;miles from a medical practice owned
or operated by Employer or its affiliate. Subject to paragraph B below, the provisions of this paragraph shall not apply to the extent that, after the date hereof, Employer enters into the business of operating a hospital or hospital system.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">B.&nbsp;&nbsp;&nbsp;&nbsp;<I>De Minimus Exception. </I>Employer agrees that a medical service line (other than those listed
in items 1 through 9 above), practice management service or other business in which Employer is engaged shall not be considered to be a part of Employer&#146;s Business if such medical service line, practice management service or other business
constitutes less than Fifteen Million Dollars ($15,000,000) of Employer&#146;s annual revenues. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">C.&nbsp;&nbsp;&nbsp;&nbsp;<I>Certain Ownership Interests. </I><B></B>It shall not be deemed to be a violation of Section&nbsp;8.1 for
Employee to: (i)&nbsp;own, directly or indirectly, one percent (1%) or less of a publicly-traded entity; or (ii)&nbsp;own, directly or indirectly, less than five percent (5%) of a privately-held business or company, if Employee is at all times a
passive investor with no board representation, management authority or other special rights to control operations of such business or company.<I> </I> </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">22 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>EXHIBIT B </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>COMPENSATION </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Performance Bonus:</B> Up to Seventy-Five Percent (75%) of
Employee&#146;s Base Salary </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Equity Compensation: </B>Employee shall be eligible for equity compensation as approved by the Compensation
Committee of the Board of Directors. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">23 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>EXHIBIT C </B></FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>FORM OF RELEASE </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>GENERAL RELEASE OF CLAIMS </I></B></FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">1. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
(&#147;<U>Employee</U>&#148;), for himself and his family, heirs, executors, administrators, legal representatives and their respective successors and assigns, in exchange for the consideration received pursuant to
Section&nbsp;5.[&nbsp;&nbsp;&nbsp;&nbsp;] of the Employment Agreement to which this release is attached as Exhibit C (the &#147;<U>Employment Agreement</U>&#148;), does hereby release and forever discharge
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (&#147;<U>Employer</U>&#148;), its subsidiaries, affiliated companies, successors and assigns, and its current or former
directors, officers, employees, shareholders or agents in such capacities (collectively with Employer, the &#147;<U>Released Parties</U>&#148;) from any and all actions, causes of action, suits, controversies, claims and demands whatsoever, for or
by reason of any matter, cause or thing whatsoever, whether known or unknown including, but not limited to, all claims under any applicable laws arising under or in connection with Employee&#146;s employment or termination thereof, whether for
discrimination, harassment, retaliation, tort, breach of express or implied employment contract, wrongful discharge, intentional infliction of emotional distress, or defamation or injuries incurred on the job or incurred as a result of loss of
employment. Employee acknowledges that Employer encouraged him to consult with an attorney of his choosing, and through this General Release of Claims encourages Employee to consult with his attorney with respect to possible claims under the Age
Discrimination in Employment Act (&#147;<U>ADEA</U>&#148;) and that he understands that the ADEA is a Federal statute that, among other things, prohibits discrimination on the basis of age in employment and employee benefits and benefit plans.
Without limiting the generality of the release provided above, Employee expressly waives any and all claims under ADEA that he may have as of the date hereof. Employee further understands that by signing this General Release of Claims he is in fact
waiving, releasing and forever giving up any claim under the ADEA as well as all other laws within the scope of this paragraph 1 that may have existed on or prior to the date hereof. Notwithstanding anything in this paragraph 1 to the contrary, this
General Release of Claims shall not apply to (i)&nbsp;any actions to enforce rights to receive any payments or benefits which may be due Employee pursuant to Section&nbsp;5.[&nbsp;&nbsp;&nbsp;&nbsp;] of the Employment Agreement, or under any of
Employer&#146;s employee benefit plans, (ii)&nbsp;any rights or claims that may arise as a result of events occurring after the date this General Release of Claims is executed, (iii)&nbsp;any indemnification rights Employee may have as a former
officer or director of Employer or its subsidiaries or affiliated companies, (iv)&nbsp;any claims for benefits under any directors&#146; and officers&#146; liability policy maintained by Employer or its subsidiaries or affiliated companies in
accordance with the terms of such policy, and (v)&nbsp;any rights as a holder of equity securities of Employer. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.&nbsp;&nbsp;&nbsp;&nbsp;Employee represents that he has not filed against the Released Parties any complaints, charges, or lawsuits
arising out of his employment, or any other matter arising on or prior to the date of this General Release of Claims, and covenants and agrees that he will never individually or with any person file, or commence the filing of, any charges, lawsuits,
complaints or proceedings with any governmental agency, or against the Released Parties with respect to any of the matters released by Employee pursuant to paragraph 1 hereof (a &#147;<U>Proceeding</U>&#148;). </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">24 </FONT></P>



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 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">3.&nbsp;&nbsp;&nbsp;&nbsp;Notwithstanding anything in this Agreement to the contrary, nothing in
this Agreement or any other agreement between Employer and Employee shall prevent Employee from filing a charge, sharing information and communicating in good faith, without prior notice to the Company, with any federal government agency having
jurisdiction over the Company or its operations, and cooperating in any investigation by any such federal government agency; However, to the maximum extent permitted by law, Employee agrees that if such an administrative claim is made, Employee
shall not be entitled to recover any individual monetary relief or other individual remedies. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">4.&nbsp;&nbsp;&nbsp;&nbsp;Employee hereby
acknowledges that Employer has informed him that he has up to <FONT STYLE="white-space:nowrap">twenty-one</FONT> (21)&nbsp;days to sign this General Release of Claims and he may knowingly and voluntarily waive that
<FONT STYLE="white-space:nowrap">twenty-one</FONT> (21)&nbsp;day period by signing this General Release of Claims earlier. Employee also understands that he shall have seven (7)&nbsp;days following the date on which he signs this General Release of
Claims within which to revoke it by providing a written notice of his revocation to Employer. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">5.&nbsp;&nbsp;&nbsp;&nbsp;Employee
acknowledges that this General Release of Claims will be governed by and construed and enforced in accordance with the internal laws of the State of Florida applicable to contracts made and to be performed entirely within such State. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">6.&nbsp;&nbsp;&nbsp;&nbsp;Employee acknowledges that he has read this General Release of Claims, that he has been advised that he should
consult with an attorney before he executes this general release of claims, and that he understands all of its terms and executes it voluntarily and with full knowledge of its significance and the consequences thereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">7.&nbsp;&nbsp;&nbsp;&nbsp;This General Release of Claims shall take effect on the eighth day following Employee&#146;s execution of this
General Release of Claims unless Employee&#146;s written revocation is delivered to Employer within seven (7)&nbsp;days after such execution. </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P><DIV ALIGN="right">
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<TD VALIGN="top"><U>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</U>, 20<U>&nbsp;&nbsp;&nbsp;&nbsp;</U></TD></TR>
</TABLE></DIV>
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<TYPE>EX-10.30
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<DESCRIPTION>EX-10.30
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 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Exhibit 10.30 </B></FONT></P> <P STYLE="margin-top:24px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>EMPLOYMENT AGREEMENT </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>THIS EMPLOYMENT AGREEMENT</B> (this
&#147;Agreement&#148;) is made and entered into by and between <B>MEDNAX SERVICES, INC.</B>, a Florida corporation (&#147;Employer&#148;) and <B>DAVID A. CLARK</B> (&#147;Employee&#148;) effective as the Effective Date. </FONT></P>
<P STYLE="margin-top:24px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>RECITALS </B></FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>WHEREAS</B>,<B> </B>Employer is presently engaged in &#147;Employer&#146;s Business&#148; as defined on Exhibit A hereto; and
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>WHEREAS</B>,&nbsp;&nbsp;&nbsp;&nbsp;Employee has previously served in various management positions with the Employer,
it&#146;s predecessor company and their affiliates, and was promoted to President, Mednax National Medical Group in January 2017; and </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>WHEREAS</B>,&nbsp;&nbsp;&nbsp;&nbsp;Employer and Employee previously entered in an Employment Agreement dated August&nbsp;11, 2008, as amended (the &#147;Prior Employment Agreement&#148;), which will
be allowed to expire by its terms on August&nbsp;10, 2018 and will not be renewed; and </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>WHEREAS</B>,&nbsp;&nbsp;&nbsp;&nbsp;Employer desires to employ Employee and benefit from Employee&#146;s contributions to Employer;
and </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>WHEREAS</B>, in order to induce Employer to enter into this Agreement on the terms and conditions set forth herein
(including an increase in compensation over what was provided under the Prior Employment Agreement), and disclose its trade secrets and confidential information in connection with Employee&#146;s employment by Employer and award from time to time
equity based compensation, Employee hereby agrees to be bound by the terms of this Agreement, including the arbitration, <FONT STYLE="white-space:nowrap">non-competition</FONT> and related restrictive covenants set forth herein. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>NOW, THEREFORE</B>, in consideration of the premises and mutual covenants set forth herein, the parties agree as follows: </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>1.&nbsp;&nbsp;&nbsp;&nbsp;Employment. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">1.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Employment and Term</I>. Employer hereby agrees to employ Employee and Employee hereby agrees to serve Employer on the terms and conditions set forth herein for an
&#147;Initial Term&#148; commencing February&nbsp;12, 2018<B> </B>(the &#147;Effective Date&#148;) and continuing for a period of three (3)&nbsp;years, unless sooner terminated as hereinafter set forth. Thereafter, the employment of Employee
hereunder shall automatically renew for successive one (1)&nbsp;year periods until terminated in accordance herewith. The Initial Term and any automatic renewals shall be referred to as the &#147;Employment Period.&#148; </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">1.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>Duties of Employee</I>. During the Employment Period, Employee shall serve as President, Mednax National
Medical Group for Employer and perform such duties as are customary to the position Employee holds or as may be assigned to Employee from time to time by Employee&#146;s </FONT></P>

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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
supervisor (&#147;Employee&#146;s Supervisor&#148;); <I>provided, </I>that such duties as assigned shall be customary to Employee&#146;s role as an officer of Employer. Employee&#146;s employment
shall be full-time and as such Employee agrees to devote substantially all of Employee&#146;s attention and professional time to the business and affairs of Employer. Employee shall perform Employee&#146;s duties honestly, diligently, competently,
in good faith and in the best interest of Employer. Employee will devote best efforts to the promotion of the goodwill of Employer and of its employees and affiliates. During the Employment Term, Employer shall promote the proficiency of Employee
by, among other things, providing Employee with Confidential Information, specialized professional development programs, and information regarding the organization, administration and operation of Employer. During the Employment Period, Employee
agrees that Employee will not, without the prior written consent of Employer (which consent shall not be unreasonably withheld), serve as a director on a corporate board of directors or in any other similar capacity for any institution other than
Employer. During the Employment Period, it shall not be a violation of this Agreement to (i)&nbsp;serve on civic or charitable boards or committees, or (ii)&nbsp;deliver lectures, fulfill speaking engagements or teach at educational institutions, so
long as such activities have been approved by Employer&#146;s General Counsel and do not interfere with the performance of Employee&#146;s responsibilities as an employee of Employer in accordance with this Agreement, including the restrictions of
Section&nbsp;8 hereof. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">1.3.&nbsp;&nbsp;&nbsp;&nbsp;<I>Place of Performance</I>. Employee shall be based at Employer&#146;s
offices located in Sunrise, Florida, except for required travel relating to Employer&#146;s Business. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>2.&nbsp;&nbsp;&nbsp;&nbsp;Base Salary and Performance Bonus. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Base Salary</I>. Employee shall be paid an annual base salary as determined by Employee&#146;s supervisor
from time to time (the &#147;Base Salary&#148;), payable in installments consistent with Employer&#146;s customary payroll schedule and subject to applicable withholding for taxes and other Employee directed withholdings. Any increase to
Employee&#146;s Base Salary that is approved by Employee&#146;s Supervisor shall become Employee&#146;s new Base Salary for purposes of this Agreement. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">2.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>Performance Bonus</I>. Employee shall be eligible for an annual bonus of up to the amount set forth on Exhibit B (the &#147;Performance Bonus&#148;). The amount of the
actual bonus paid to Employee, if any, shall be based upon the achievement of specific objectives to be developed and agreed upon by Employee and Employee&#146;s Supervisor each year and the performance of Employer. Except in the situations
described in Sections 5.2, 5.3, 5.4, 5.5 and 5.7, the Performance Bonus shall only be payable to Employee if Employee is employed with Employer as of the date that the Performance Bonus is paid by Employer. Each Performance Bonus shall be paid in
the calendar year immediately following the calendar year in which it is earned, as soon as practicable after the audited financial statements for Employer for the year for which the bonus is earned have been released; provided, however, that if
calculation of Employee&#146;s Performance Bonus is not administratively practicable due to events beyond the control of Employer, then Employer may delay payment of the Performance Bonus provided that the payment is made during the first taxable
year of Employee in which the calculation of the amount of the payment is administratively practicable. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">2 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>3.&nbsp;&nbsp;&nbsp;&nbsp;Benefits. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Expense Reimbursement</I>. Employer shall promptly reimburse Employee for all <FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-pocket</FONT></FONT> expenses reasonably incurred by Employee during the Employment Period on behalf of or in connection with Employer&#146;s Business pursuant to the reimbursement
standards and guidelines of Employer in effect from time to time. Employee shall account for such expenses and submit reasonable supporting documentation to Employer in accordance with Employer&#146;s policies in effect from time to time.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.2&nbsp;&nbsp;&nbsp;&nbsp;<I>Employee Benefits</I>. During the Employment Period, Employee shall be entitled to participate
in such health, welfare, disability, retirement savings and other fringe benefit plans and programs (subject to the terms and conditions of such plans and programs) as may be provided from time to time to employees of Employer and to the extent that
such plans and programs are applicable to other similarly situated employees of Employer. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.3.&nbsp;&nbsp;&nbsp;&nbsp;<I>Leave Time</I>. During the Employment Period, Employee shall be entitled to paid vacation and leave days
each calendar year in accordance with the leave policies established by Employer from time to time, but in no event less than thirty-eight (38)&nbsp;days per year. Any leave time not used during each fiscal year of Employer may be carried over into
the next year to the extent permitted by Employer policy. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.4&nbsp;&nbsp;&nbsp;&nbsp;<I>Equity Plans. </I>During the
Employment Period, Employee shall be eligible to participate in MEDNAX, Inc.&#145;s Amended and Restated 2008 Incentive Compensation Plan, as amended, or any other similar plan adopted by MEDNAX, Inc. (each an &#147;Equity Plan&#148;) that provides
for the issuance of stock options, stock appreciation rights, restricted stock, deferred stock, bonus stock, awards payable in stock or any other stock based award (each an &#147;Equity Award&#148;). Employee&#146;s stock-based award each year shall
be determined by the Compensation Committee of MEDNAX, Inc.&#146;s Board of Directors based on Employee&#146;s performance and Employer&#146;s performance during the immediately preceding year and shall be at least consistent with the Compensation
Committee&#146;s determination of Employee&#146;s stock-based award in prior years. Every Equity Award made to Employee shall be subject to the terms and conditions of this Agreement, the applicable award agreement and the terms of the Equity Plan.
Employee shall also be eligible to participate in MEDNAX, Inc.&#146;s <FONT STYLE="white-space:nowrap">non-qualified</FONT> employee stock purchase plan and any successor plan. Employee acknowledges Employee&#146;s participation in the Equity Plan
pursuant to this Section&nbsp;3 is sufficient consideration for Employee to enter into this Agreement, including the restrictive covenants set forth in Section&nbsp;8 below<I>. </I> </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>4.&nbsp;&nbsp;&nbsp;&nbsp;Termination. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">4.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination for Cause</I>. Employer may terminate Employee&#146;s employment under this Agreement for Cause. As used in this Agreement, the term &#147;Cause&#148; shall
mean: </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a)&nbsp;&nbsp;&nbsp;&nbsp;Any act or omission of Employee, which is materially contrary to the business
interests, reputation or goodwill of Employer; </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(b)&nbsp;&nbsp;&nbsp;&nbsp;A material breach by Employee of
Employee&#146;s obligations under this Agreement, which breach is not promptly remedied upon written notice from Employer; </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">3 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(c)&nbsp;&nbsp;&nbsp;&nbsp;Employee&#146;s refusal to perform
Employee&#146;s duties as assigned pursuant to this Agreement other than a refusal which is remedied by Employee promptly after receipt of written notice thereof by Employer; or </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(d)&nbsp;&nbsp;&nbsp;&nbsp;Employee&#146;s failure or refusal to comply with a reasonable policy, standard or regulation
of Employer in any material respect, including but not limited to Employer&#146;s sexual harassment, other unlawful harassment, workplace discrimination or substance abuse policies. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2">The termination date for a termination of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.1 shall be the date specified by Employer in a written notice to Employee of
finding of Cause, which may not be retroactive. Upon any termination of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.1, Employee shall be entitled to the compensation specified in Section&nbsp;5.1 hereof.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>Disability</I>. Employer may terminate Employee&#146;s employment under this Agreement upon
the Disability (as defined below) of Employee. Subject to the requirements of applicable law, Employee shall be deemed to have a &#147;Disability&#148; for purposes of this Agreement in the event of (i)&nbsp;Employee&#146;s inability to perform
Employee&#146;s duties hereunder, with or without a reasonable accommodation, as a result of physical or mental illness or injury, and (ii)&nbsp;a determination by an independent qualified physician selected by Employer and acceptable to Employee
(which acceptance shall not be unreasonably withheld) that Employee is currently unable to perform such duties and in all reasonable likelihood such inability will continue for a period in excess of an additional ninety (90)&nbsp;or more days in any
one hundred twenty (120)&nbsp;day period. The termination date for a termination of this Agreement pursuant to this Section&nbsp;4.2 shall be the date specified by Employer in a notice to Employee, which date shall not be retroactive. Upon any
termination of this Agreement pursuant to this Section&nbsp;4.2, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.2 hereof. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.3.&nbsp;&nbsp;&nbsp;&nbsp;<I>Death</I>. Employee&#146;s employment under this Agreement shall terminate automatically upon the death of
Employee, without any requirement of notice by Employer to Employee&#146;s estate. The date of Employee&#146;s death shall be the termination date for a termination of Employee&#146;s employment under this Agreement pursuant to this
Section&nbsp;4.3. Upon any termination of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.3, Employee shall be entitled to the compensation specified in Section&nbsp;5.3 hereof. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.4.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employer Without Cause</I>. Employer may terminate Employee&#146;s employment without cause
by giving Employee written notice of such termination. The termination date shall be the date specified by Employer in such notice, which may be up to ninety (90)&nbsp;days from the date of such notice. Upon any termination of Employee&#146;s
employment under this Agreement pursuant to this Section&nbsp;4.4, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.4 hereof. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">4 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.5.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employee Due to Poor Health</I>. Employee may
terminate Employee&#146;s employment under this Agreement upon written notice to Employer if Employee&#146;s health should become impaired to any extent that makes the continued performance of Employee&#146;s duties under this Agreement hazardous to
Employee&#146;s physical or mental health or Employee&#146;s life (regardless of whether such condition would be deemed a Disability under any other Section of this Agreement), <I>provided </I>that Employee shall have furnished Employer with a
written statement from a qualified doctor to that effect, and <I>provided further</I> that, at Employer&#146;s written request and expense, Employee shall submit to a medical examination by an independent qualified physician selected by Employer and
acceptable to Employee (which acceptance shall not be unreasonably withheld), which doctor shall substantially concur with the conclusions of Employee&#146;s doctor. The termination date shall be the date specified in Employee&#146;s notice to
Employer, which date may not be earlier than thirty (30)&nbsp;days nor later than ninety (90)&nbsp;days from Employer&#146;s receipt of such notice. Upon any termination of Employee&#146;s employment under this Agreement pursuant to this
Section&nbsp;4.5, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.5 hereof. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">4.6.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employee</I>. Employee may terminate Employee&#146;s employment under this Agreement for any reason whatsoever upon not less than ninety (90)&nbsp;days prior
written notice to Employer. Upon receipt of such notice from Employee, Employer may, at its option, require Employee to terminate employment at any time in advance of the expiration of such ninety (90)&nbsp;day period. The termination date under
this Section&nbsp;4.6 shall be the date specified by Employer, but in no event more than ninety (90)&nbsp;days after Employer&#146;s receipt of notice from Employee as contemplated by this Section. Upon any termination of Employee&#146;s employment
under this Agreement pursuant to this Section&nbsp;4.6, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.6 hereof. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.7.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employee for Good Reason. </I>Employee may terminate Employee&#146;s employment hereunder
for Good Reason. For purposes of this Section, &#147;Good Reason&#148; shall mean: </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a)
&nbsp;&nbsp;&nbsp;&nbsp;a decrease in Employee&#146;s Base Salary; </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(b) &nbsp;&nbsp;&nbsp;&nbsp;a decrease in
the Performance Bonus potential utilized by Employer in determining a Performance Bonus for Employee; or </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(c)&nbsp;&nbsp;&nbsp;&nbsp;within a twenty-four (24)&nbsp;month period after a Change in Control (as defined below),
Employee is either (i)&nbsp;assigned any position, duties, responsibilities or compensation that is inconsistent with the position, duties, responsibilities or compensation of Employee prior to such Change in Control, (ii)&nbsp;required to report to
any person other than the President or Chief Executive Officer of Employer in place just prior to the Change in Control (unless Employee becomes Chief Executive Officer of Employer or its equivalent and reports directly to the Board, as defined
below), or (iii)&nbsp;required to perform services under this Agreement from another location more than twenty-five (25)&nbsp;miles from Employee&#146;s location prior to the Change in Control. For purposes of this Agreement, &#147;Change in
Control&#148; shall mean (i)&nbsp;the acquisition by a person or an entity or a group of persons and entities, directly or indirectly, of more than fifty (50%) percent of MEDNAX, Inc.&#146;s common
</FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">5 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">
stock in a single transaction or a series of transactions (hereinafter referred to as a &#147;50% Change in Control&#148;), (ii) a merger or other form of corporate reorganization of MEDNAX, Inc.
resulting in an actual or <I>de facto</I> 50% Change in Control, or (iii)&nbsp;the failure of Applicable Directors (defined below) to constitute a majority of MEDNAX, Inc.&#146;s Board of Directors (the &#147;Board&#148;) during any two
(2)&nbsp;consecutive year period after the date of this Agreement (the <FONT STYLE="white-space:nowrap">&#147;Two-Year</FONT> Period&#148;). &#147;Applicable Directors&#148; shall mean those individuals who are members of the Board at the inception
of a <FONT STYLE="white-space:nowrap">Two-Year</FONT> Period and any new director whose election to the Board or nomination for election to the Board was approved (prior to any vote thereon by the shareholders) by a vote of at least <FONT
STYLE="white-space:nowrap">two-thirds</FONT> (2/3) of the directors then still in office who either were directors at the beginning of the <FONT STYLE="white-space:nowrap">Two-Year</FONT> Period at issue or whose election or nomination for election
during such <FONT STYLE="white-space:nowrap">Two-Year</FONT> Period was previously approved as provided in this sentence; or </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(d)&nbsp;&nbsp;&nbsp;&nbsp;the assignment to Employee of any position inconsistent with the present position Employee holds, or material diminution in Employee&#146;s authority, excluding for this purpose
any isolated, insubstantial and inadvertent action not taken in bad faith and which is remedied by Employer promptly after receipt of written notice; or </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(e)&nbsp;&nbsp;&nbsp;&nbsp;the requirement by Employer that Employee be based in any office or location outside of the metropolitan area where Employer&#146;s present corporate offices are located (it
being understood that Employee may be presently based at another location), except for travel reasonably required in the performance of Employee&#146;s duties. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(f)&nbsp;&nbsp;&nbsp;&nbsp;any other action or inaction that constitutes a material breach of this Agreement by Employer. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2">If Employee desires to terminate Employee&#146;s employment under this Agreement pursuant to this Section, Employee must, within ninety (90)&nbsp;days after the occurrence of events giving rise to the
Good Reason, provide Employer with a written notice describing the Good Reason in reasonable detail. If Employer fails to cure the matter cited within thirty (30)&nbsp;days after the date of Employee&#146;s notice, then this Agreement shall
terminate as of the end of such thirty (30)&nbsp;day cure period, <I>provided, however, </I>that Employer may, at its option, require Employee to terminate employment at any time in advance of the expiration of such thirty (30)&nbsp;day cure period.
If Employee terminates Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.7, then Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.7 hereof.
</FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>5.&nbsp;&nbsp;&nbsp;&nbsp;Compensation and Benefits Upon Termination. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Cause</I>. If Employee&#146;s employment is terminated for Cause, Employer shall pay Employee&#146;s Base
Salary through the termination date specified in Section&nbsp;4.1 at the rate in effect at the termination date. Upon payment of such amounts, plus any amounts as may be due under Section&nbsp;5.8 below, Employer shall have no further obligation to
Employee under this Agreement. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">6 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>Disability</I>.&nbsp;&nbsp;&nbsp;&nbsp;In the event of
Employee&#146;s Disability, Employee shall continue to receive Employee&#146;s Base Salary for the first ninety (90)&nbsp;days of Disability. Thereafter, payments, if any, shall be administered pursuant to Employer&#146;s sponsored long-term
disability policy. If Employee&#146;s employment is terminated pursuant to Section&nbsp;4.2 in connection with Employee&#146;s Disability, Employee shall receive fifty percent (50%) of Employee&#146;s annual Base Salary at the rate in effect at the
termination date, payable in six (6)&nbsp;equal monthly installments after the termination date, plus a bonus calculated in accordance with Section&nbsp;5.11 and any amounts as may be due under Section&nbsp;5.8 and 5.9. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.3.&nbsp;&nbsp;&nbsp;&nbsp;<I>Death</I>. Upon Employee&#146;s death during the Employment Period, Employer shall pay to the person or
entity designated by Employee in a notice filed with Employer or, if no person is designated, to Employee&#146;s estate any unpaid amounts of Base Salary to the date of Employee&#146;s death, plus any amounts as may be due under Sections 5.8 and
5.11 below. Any payments Employee&#146;s spouse, beneficiaries or estate may be entitled to receive pursuant to any pension plan, employee welfare benefit plan, life insurance policy, or similar plan or policy then maintained by Employer shall be
determined and paid in accordance with the written instruments governing the respective plans and policies. In the event of Employee&#146;s death during the Employment Period, Employer shall notify Employee&#146;s designee or estate of the Equity
Awards held by Employee and the procedures pursuant to which all vested stock options may be exercised and other Equity Awards may be realized under the terms applicable to such awards. Upon full payment of all amounts required to be paid under this
Section&nbsp;5.3, Employer shall have no further obligation under this Agreement. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%;padding-bottom:0px; "><FONT STYLE="font-family:Times New Roman" SIZE="2">5.4.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employer Without Cause</I>. If Employer terminates Employee&#146;s
employment in accordance with Section&nbsp;4.4, then (i)&nbsp;Employer shall pay Employee&#146;s Base Salary through the termination date specified in Section&nbsp;4.4 at the rate in effect at such termination date, plus any amount due under
Section&nbsp;5.8 hereof; (ii)&nbsp;within thirty (30)&nbsp;days, pay Employee a bonus calculated in accordance with Section&nbsp;5.11 hereof; (iii)&nbsp;Employer shall continue to pay Employee&#146;s monthly Base Salary for a period of eighteen
(18)&nbsp;months after the termination date; (iv)&nbsp;within thirty (30)&nbsp;days of the first (1</FONT><FONT STYLE="font-family:Times New Roman" SIZE="1"><SUP STYLE="vertical-align:baseline; position:relative; bottom:.8ex">st</SUP></FONT><FONT
STYLE="font-family:Times New Roman" SIZE="2">)&nbsp;anniversary of the termination date, pay Employee an amount equal to Employee&#146;s Average Annual Performance Bonus (as defined below); and (v)&nbsp;if applicable, Employee shall vest into the
Accelerated Awards (as defined below) as set forth in Section&nbsp;5.14 hereof. For purposes of this Agreement, &#147;Average Annual Performance Bonus&#148; shall be equal to the average of the percentage of the Performance Bonus target achieved by
Employee for the three (3)&nbsp;full calendar years prior to the termination date, and calculated based on Employee&#146;s Base Salary and target Performance Bonus in Employee&#146;s current position. <I>For illustration purposes, if Employee earned
40%, 100% and 70% of Employee&#146;s target Performance Bonus in each of the three full calendar years prior to termination, and Employee&#146;s current target Performance Bonus was 100% of Base Salary, and Base Salary was $450,000.00, then
Employee&#146;s Average Annual Performance Bonus would equal $315,000.00. ((40%+ 100% + 70%) / 3 x 100% x $450,000.00 = $315,000.00). </I>Upon payment of the amounts specified under Sections 5.4 and 5.11, Employer shall have no further obligation
under this Agreement. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.5.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employee Due to Poor Health. </I>If Employee terminates
Employee&#146;s employment under this Agreement pursuant to Section&nbsp;4.5 hereof, Employer shall pay to Employee any unpaid amounts of Base Salary to the termination date specified in Section&nbsp;4.5, plus any disability payments otherwise
payable by or pursuant to plans provided by Employer, plus any amounts as may be due under Section&nbsp;5.8 and 5.11 below. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">7 </FONT></P>


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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.6.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination by Employee</I>. If Employee&#146;s employment
under this Agreement terminates pursuant to Section&nbsp;4.6 hereof, Employer shall pay to Employee any unpaid amounts of Base Salary to the termination date specified in Section&nbsp;4.6, plus any amounts as may be due under Section&nbsp;5.8 below.
In the event that the termination date specified by Employer is less than ninety (90)&nbsp;days after the date of Employer&#146;s receipt of notice as contemplated by Section&nbsp;4.6, then Employer shall continue Employee&#146;s Base Salary for a
period of days equal to ninety (90)&nbsp;minus the number of days from Employee&#146;s notice to the termination date. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.7.&nbsp;&nbsp;&nbsp;&nbsp;<I>Termination for Good Reason.</I><B> </B>If Employee&#146;s employment under this Agreement is terminated
pursuant to Sections&nbsp;4.7(a), (b), (d), (e), or (f), then Employer shall (i)&nbsp;pay Employee&#146;s Base Salary through the termination date specified in Section&nbsp;4.7 at the rate in effect at such termination date, (ii)&nbsp;pay any
amounts as may be due under Section&nbsp;5.8 and 5.11, and (iii)&nbsp;continue to pay Employee&#146;s Base Salary for a period of twelve (12)&nbsp;months after the termination date. If this Agreement is terminated pursuant to Section&nbsp;4.7(c),
then Employer shall (i)&nbsp;pay Employee&#146;s Base Salary through the termination date specified in Section&nbsp;4.7 at the rate in effect at such termination date, (ii)&nbsp;pay any amounts as may be due under Sections 5.8 and 5.11, and
(iii)&nbsp;continue to pay Employee&#146;s Base Salary for a period of eighteen (18)&nbsp;months after the termination date. <B></B>In addition, notwithstanding any contrary provision in any Equity Plan, in the event of Employee&#146;s termination
pursuant to Section&nbsp;4.7(c), any unvested Equity Awards held by Employee on the termination date shall fully vest and in the case of stock options, become immediately exercisable. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.8.&nbsp;&nbsp;&nbsp;&nbsp;<I>Expense Reimbursement. </I>Employee shall be entitled to reimbursement for reasonable business expenses
incurred prior to the termination date, subject, however to the provisions of Section&nbsp;3.1. Such reimbursement shall be made at the times and in accordance with Employer&#146;s normal procedures for reimbursements. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.9.&nbsp;&nbsp;&nbsp;&nbsp;<I>Continuation of Benefit Plans</I>. Employee shall be entitled to continuation of health, medical,
hospitalization and other similar health insurance programs on the same basis as regular, full-time employees of Employer and their eligible dependents during the period that Employee is receiving Base Salary payments under Section&nbsp;5 of this
Agreement and, in all cases, as provided by any applicable law. Following such period of continued benefit plan coverage, Employee and each of his eligible dependents shall be entitled to elect for continuation of coverage provided pursuant to
Section&nbsp;601 et. seq. of the Employee Retirement Income Security Act of 1974, 29 USC &#167;1101 (&#147;COBRA&#148;). </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.10&nbsp;&nbsp;&nbsp;&nbsp;<I>Period for Exercising Stock Options After Termination. </I>Except as to incentive stock options granted in
accordance with Section&nbsp;422 of the Internal Revenue Code, after termination of Employee&#146;s employment under this Agreement for any reason other than pursuant to Section&nbsp;4.1, Employee shall be allowed a period of one hundred eighty
(180)&nbsp;days during which to exercise any vested options to purchase MEDNAX, Inc.&#146;s common stock or vested stock appreciation rights and realize any other vested Equity Awards that may be granted or made under any Equity Plan; provided,
however, that in no event shall the period during which Employee may exercise any vested stock option or vested stock appreciation right be extended pursuant to this Section&nbsp;5.10 to a date that is later than the earlier of (i)&nbsp;the latest
date upon which the stock right </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">8 </FONT></P>


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could have expired by its original terms under any circumstances or (ii)&nbsp;the tenth (10</FONT><FONT STYLE="font-family:Times New Roman" SIZE="1"><SUP
STYLE="vertical-align:baseline; position:relative; bottom:.8ex">th</SUP></FONT><FONT STYLE="font-family:Times New Roman" SIZE="2">) anniversary of the original date of grant of the stock right. In all other respects, the terms of the applicable
Equity Plan shall control the terms and conditions of any Equity Awards. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.11.&nbsp;&nbsp;&nbsp;&nbsp;<I>Performance Bonus.
</I>In the situations described in Sections 5.2, 5.3, 5.4, 5.5 and 5.7, upon termination of this Agreement, Employee<B> </B>will be paid, solely in consideration of services rendered by Employee prior to termination, a bonus with respect to
Employer&#146;s fiscal year in which the termination date occurs, equal to the Performance Bonus, if any, that would have been payable to Employee, based on Employee and Employer meeting certain goals and objectives, for the fiscal year if
Employee&#146;s employment had not been terminated, multiplied by the number of days in the fiscal year prior to and including the date of termination and divided by three hundred sixty five (365). The amount of the Post-Termination Performance
Bonus paid in the situations described in Sections 5.2, 5.3, 5.4 5.5 and 5.7 shall be determined in good faith by Employer in its sole discretion at the time that Employer distributes bonuses to similarly situated employees. Any amount payable under
this Section&nbsp;5.11 shall be paid to Employee when Employer pays performance bonuses to its eligible employees, which shall be in the calendar year following the termination date of this Agreement. In addition, in the situations described in
Section&nbsp;5.7, Employee will be paid, solely in consideration of services rendered by Employee prior to termination, an additional bonus with respect to Employer&#146;s fiscal year in which the termination date occurs, equal to the greater of
Employee&#146;s Average Annual Performance Bonus (as defined in Section&nbsp;5.4) or Employee&#146;s bonus for the year immediately preceding Employee&#146;s termination. Such additional bonus shall be payable to Employee within ninety
(90)&nbsp;days of Employee&#146;s termination date pursuant to Section&nbsp;4.7. </FONT></P>
<P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.12.&nbsp;&nbsp;&nbsp;&nbsp;<I>Section</I> <I>409A Compliance</I>. </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a)&nbsp;&nbsp;&nbsp;&nbsp;General.<B> </B>It is the intention of both Employer and Employee that the benefits and rights
to which Employee could be entitled in connection with termination of employment comply with Section&nbsp;409A of the Code and the Treasury Regulations and other guidance promulgated or issued thereunder (&#147;Section&nbsp;409A&#148;), and the
provisions of this Agreement shall be construed in a manner consistent with that intention. If Employee or Employer believes, at any time, that any such benefit or right does not so comply, it shall promptly advise the other and shall negotiate
reasonably and in good faith to amend the terms of such benefits and rights such that they comply with Section&nbsp;409A of the Code (with the most limited possible economic effect on Employee and on Employer). </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(b)&nbsp;&nbsp;&nbsp;&nbsp;Distributions on Account of Separation from Service.<B> </B>If and to the extent required to
comply with Section&nbsp;409A, no payment or benefit required to be paid under this Agreement on account of termination of Employee&#146;s employment shall be made unless and until Employee incurs a &#147;separation from service&#148;, within the
meaning of Section&nbsp;409A. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(c)&nbsp;&nbsp;&nbsp;&nbsp;6 Month Delay for Specified Employees. </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(i)&nbsp;&nbsp;&nbsp;&nbsp;If Employee is a &#147;specified employee&#148;, then no payment or benefit that is payable on account of
Employee&#146;s &#147;separation from service&#148;, as that term is defined for purposes of Section&nbsp;409A, shall be made before the date that is six months after Employee&#146;s &#147;separation from service&#148; (or, if earlier, the date of
Employee&#146;s death) if </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">9 </FONT></P>


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and to the extent that such payment or benefit constitutes deferred compensation (or may be nonqualified deferred compensation) under Section&nbsp;409A and such deferral is required to comply
with the requirements of Section&nbsp;409A. Any payment or benefit delayed by reason of the prior sentence shall be paid out or provided in a single lump sum at the end of such required delay period in order to catch up to the original payment
schedule. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(ii)&nbsp;&nbsp;&nbsp;&nbsp;For purposes of this provision, Employee shall be considered to be a
&#147;specified employee&#148; if, at the time of his or her separation from service, Employee is a &#147;key employee&#148;, within the meaning of Section&nbsp;416(i) of the Code, of Employer (or any person or entity with whom Employer would be
considered a single employer under Section&nbsp;414(b) or Section&nbsp;414(c) of the Code) any stock in which is publicly traded on an established securities market or otherwise. </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(iii)&nbsp;&nbsp;&nbsp;&nbsp;Unless otherwise required to comply with Section&nbsp;409A, a payment or benefit shall not be
deferred pursuant to this provision if: </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:13%; text-indent:4%;padding-bottom:0px; "><FONT STYLE="font-family:Times New Roman" SIZE="2">(x)&nbsp;&nbsp;&nbsp;&nbsp;it is not made on
account of Employee&#146;s &#147;separation from service&#148;, (y) it is required to be paid no later than within 2<FONT SIZE="1"><SUP STYLE="vertical-align:baseline; position:relative; bottom:.8ex">&nbsp;1</SUP></FONT><FONT SIZE="2">/</FONT><FONT
SIZE="1"><SUB STYLE="vertical-align:baseline; position:relative; top:.1ex">2</SUB></FONT><FONT STYLE="font-family:Times New Roman" SIZE="2"> months after the end of the taxable year of Employee in which the payment or benefit is no longer subject to
a &#147;substantial risk of forfeiture&#148;, as that term is defined for purposes of Section&nbsp;409A, or (z)&nbsp;the payment satisfies the following requirements: (A)&nbsp;it is being paid or provided due to Employer&#146;s termination of
Employee&#146;s employment without Cause (Section 4.4) or Employee&#146;s termination of employment after a Change in Control for the reasons set forth in Section&nbsp;4.7 hereof, (B)&nbsp;it does not exceed two times the lesser of
(1)&nbsp;Employee&#146;s annualized compensation from Employer for the calendar year prior to the calendar year in which the termination of Employee&#146;s employment occurs, and (2)&nbsp;the maximum amount of compensation that may be taken into
account under a qualified plan pursuant to Section&nbsp;401(a)(17) of the Code for the year in which Employee&#146;s employment terminates, and (C)&nbsp;the payment is required under this Agreement to be paid no later than the last day of the second
calendar year following the calendar year in which Employee incurs a &#147;separation from service&#148;. </FONT></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(d)&nbsp;&nbsp;&nbsp;&nbsp;No Acceleration of Payments. Neither Employer nor Employee, individually or in combination, may
accelerate any payment or benefit that is subject to Section&nbsp;409A, except in compliance with Section&nbsp;409A and the provisions of this Agreement, and no amount shall be paid prior to the earliest date on which it may be paid without
violating Section&nbsp;409A. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(e)&nbsp;&nbsp;&nbsp;&nbsp;Treatment of Each Installment as a Separate Payment.
For purposes of applying the provisions of Section&nbsp;409A to this Agreement, each separately identified amount to which Employee is entitled under this Agreement shall be treated as a separate payment. In addition, to the extent permissible under
Section&nbsp;409A, any series of installment payments under this Agreement shall be treated as a right to a series of separate payments. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">10 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:4%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(f)&nbsp;&nbsp;&nbsp;&nbsp;Reimbursements and
<FONT STYLE="white-space:nowrap">In-Kind</FONT> Benefits. </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(i)&nbsp;&nbsp;&nbsp;&nbsp;Any reimbursements by
Employer to Employee of any eligible expenses pursuant to Section&nbsp;3.1 or 5.8 of this Agreement, that are not excludible from Employee&#146;s income for Federal income tax purposes (&#147;Taxable Reimbursements&#148;) shall be made on or before
the last day of the taxable year of Employee following the year in which the expense was incurred. </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(ii)&nbsp;&nbsp;&nbsp;&nbsp;The amount of any Taxable Reimbursements, and the value of any
<FONT STYLE="white-space:nowrap">in-kind</FONT> benefits to be provided to Employee under this Agreement, during any taxable year of Employee shall not affect the expenses eligible for reimbursement, or
<FONT STYLE="white-space:nowrap">in-kind</FONT> benefits to be provided, in any other taxable year of Employee. </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(iii)&nbsp;&nbsp;&nbsp;&nbsp;The right to Taxable Reimbursements, or <FONT STYLE="white-space:nowrap">in-kind</FONT>
benefits, shall not be subject to liquidation or exchange for another benefit. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.13.&nbsp;&nbsp;&nbsp;&nbsp;<I>Release.
</I>Employer shall provide Employee with a general release in the form attached as Exhibit C (subject to such modifications as Employer may reasonably request) within seven (7)&nbsp;days after Employee&#146;s termination date.&nbsp;Payments or
benefits to which Employee may be entitled pursuant to this Section&nbsp;5 (other than any accrued but unpaid Base Salary and employee benefits as of the end of the Employment Period) (the &#147;Severance Amounts&#148;) shall be conditioned upon
Employee executing the general release within 21 days after receiving it from Employer and the general release becoming irrevocable upon the expiration of 7 days following the Employee&#146;s execution of it. Payment of the Severance Amounts shall
be suspended during the period (the &#147;Suspension Period&#148;) that begins on Employee&#146;s termination date and ends on the date (&#147;Suspension Termination Date&#148;) that is thirty-five (35)&nbsp;days after Employee&#146;s termination
date; provided, however, that this suspension shall not apply, and Employer shall be required to provide, any continued health insurance coverage that would be required under Section&nbsp;5.9 hereof during the Suspension Period. If Employee executes
the general release and the general release becomes irrevocable by no later than the Suspension Termination Date, then payment of any Severance Amounts that were suspended pursuant to this provision shall be made in the first payroll period that
follows the Suspension Termination Date, and any Severance Amounts that are payable after the Suspension Termination Date shall be paid at the times provided in Section&nbsp;5. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.14.&nbsp;&nbsp;&nbsp;&nbsp;<I>Vesting of Incentive Awards. </I>Notwithstanding any contrary provision in this Agreement or<B> </B>any
Equity Plan then maintained by MEDNAX, Inc.: </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a) all Equity Awards granted to Employee by MEDNAX, Inc. prior to termination
of this Agreement shall continue to vest until fully vested following a termination of Employee&#146;s employment pursuant to Section&nbsp;4.2, 4.3, and 4.5;<B> </B>and </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(b) in the event of a Change in Control after the date of this Agreement: </FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(i)&nbsp;&nbsp;&nbsp;&nbsp;if, prior to the one (1)&nbsp;year anniversary of the effective date of such Change in Control, the employment by MEDNAX, Inc. or its affiliates or successors of both Roger J.
Medel, M.D. and Joseph M. Calabro is terminated for any reason, or </FONT></P>
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they both no longer hold the positions they held just prior to the Change in Control (and neither holds the top executive position in the company), then the Equity Awards granted to the Employee
that are outstanding (the &#147;Accelerated Awards&#148;) shall become fully vested and payable to the Employee on the first anniversary of the effective date of such Change in Control; provided, however, that any portion of the Accelerated Awards
that is scheduled to become vested and payable pursuant to its terms prior to the first anniversary of such Change in Control shall become vested and payable to the Employee pursuant to its terms; and </FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; margin-left:8%; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(ii) &nbsp;&nbsp;&nbsp;&nbsp;if, after the one (1)&nbsp;year anniversary of the effective date of such Change in Control,
the employment by MEDNAX, Inc. or its affiliates or successors of both Roger J. Medel, M.D. and Joseph M. Calabro is terminated for any reason, or they both no longer hold the positions they held just prior to the Change in Control (provided that
neither holds the top executive position in the company), then the Accelerated Awards shall become fully vested and payable to the Employee on the one (1)&nbsp;year anniversary of the termination date, or date of the change in position of Roger J.
Medel, M.D. or Joseph M. Calabro, whichever termination date or date in change of position is later; provided, however, that any portion of the Accelerated Awards that is scheduled to become vested and payable pursuant to its terms prior to the one
(1)&nbsp;year anniversary of such termination date or date of change in position shall become vested and payable to the Employee pursuant to its terms; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2">provided in the case of both clauses (i)&nbsp;and (ii) above, that the Employee remains in Continuous Service (as defined in the applicable Equity Plan) from the date of this Agreement through the date on
which such Accelerated Awards would vest pursuant to clauses (i)&nbsp;or (ii) above, as applicable. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">(iii)&nbsp;&nbsp;&nbsp;&nbsp;if at any time after a Change in Control after the date of this Agreement, Employee&#146;s employment is
terminated pursuant to Section&nbsp;4.4 or 4.7(a),(b)(d)&nbsp;(e) or (f), then all of the Accelerated Awards will be fully vested and exercisable as of the effective date of such termination. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Notwithstanding anything to the contrary in this Agreement, the Equity Plans or the Equity Awards, in the event of a Change in Control
immediately following which neither the common stock of MEDNAX, Inc. nor the common equity of its successor, parent or subsidiary is listed for trading on a national securities exchange (a &#147;Going Private Transaction&#148;), then all unvested
Equity Awards granted to the Employee shall be adjusted so that in lieu of the Employee&#146;s right to receive shares of common stock of MEDNAX, Inc. pursuant to the terms of such Equity Awards, the Employee shall be entitled to receive, for each
share of common stock of MEDNAX, Inc. that Employee would otherwise be entitled to receive pursuant to such Equity Awards, an amount of cash equal to the amount per share of common stock of MEDNAX, Inc. paid to the shareholders of MEDNAX, Inc. in
such Going Private Transaction, as determined by the Compensation Committee of the Board in its sole discretion, in each case consistent with the vesting schedule of such Equity Awards and shall remain subject to the acceleration provisions set
forth in this Section&nbsp;5.14. </FONT></P>
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 <P STYLE="margin-top:0px;margin-bottom:0px; margin-left:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>6.&nbsp;&nbsp;&nbsp;&nbsp;Successors; Binding Agreement. </B></FONT></P>
<P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">6.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>Successors</I>. Employer shall require any successor (whether direct or indirect, by purchase, merger,
consolidation or otherwise) acquiring a majority of Employer&#146;s voting common stock or any other successor to all or substantially all of the business and/or assets of Employer to expressly assume and agree to perform this Agreement in the same
manner and to the same extent that Employer would be required to perform it if no such succession had taken place and Employee hereby consents to any such assignment. In such event, &#147;Employer&#148; shall mean Employer as previously defined and
any successor to its business and/or assets which executes and delivers the agreement provided for in this Section&nbsp;6 or which otherwise becomes bound by all the terms and provisions of this Agreement by operation of law. This Section shall not
limit Employee&#146;s ability to terminate this Agreement in the circumstances described in Section&nbsp;4.7 in the event of a Change in Control. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">6.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>Benefit</I>. This Agreement and all rights of Employee under this Agreement shall inure to the benefit of and be enforceable by Employee&#146;s personal or legal
representatives, executors, administrators, successors, heirs, distributees, devisees and legatees. If Employee should die after the termination date and amounts would have been payable to Employee under this Agreement if Employee had continued to
live, including under Section&nbsp;5 hereof, then such amounts shall be paid to Employee&#146;s devisee, legatee, or other designee or, if there is no such designee, Employee&#146;s estate. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>7.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Conflicts with Prior Employment Contract. </B>Except as otherwise provided in this Agreement with
respect to the August&nbsp;11, 2018 expiration of the Prior Employment Agreement, this Agreement constitutes the entire agreement among the parties pertaining to the subject matter hereof, and supersedes and revokes any and all prior or existing
agreements, written or oral, relating to the subject matter hereof, and this Agreement shall be solely determinative of the subject matter hereof. </FONT></P> <P STYLE="margin-top:18px;margin-bottom:0px; margin-left:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>8.&nbsp;&nbsp;&nbsp;&nbsp;Restrictive Covenants; Confidential Information; Work Product; Injunctive Relief. </B></FONT></P> <P STYLE="margin-top:6px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">8.1.&nbsp;&nbsp;&nbsp;&nbsp;<I>No Material Competition</I>. Employer and Employee acknowledge and agree that a strong relationship and connection exists between Employer and its current and prospective
patients, referral sources, and customers as well as the hospitals and healthcare facilities at which it provides professional services. Employer and Employee further acknowledge and agree that the restrictive covenants described in this Section are
designed to enforce, and are ancillary to or part of, the promises contained in this Agreement and are reasonably necessary to protect the legitimate interests of Employer in the following: (1)&nbsp;the use and disclosure of the Confidential
Information as described in Section&nbsp;8.4; (2) the professional development activities described in Section&nbsp;1.2; and (3)&nbsp;the goodwill of the Employer, as promoted by Employee as provided in Section&nbsp;1.2. The foregoing listing is by
way of example only and shall not be construed to be an exclusive or exhaustive list of such interests. Employee acknowledges that the restrictive covenants set forth below are of significant value to Employer and were a material inducement to
Employer in agreeing to the terms of this Agreement. Employee further acknowledges that the goodwill and other proprietary interest of Employer will suffer irreparable and continuing damage in the event Employee enters into competition with Employer
in violation of this Section. </FONT></P>
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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">Therefore, Employee agrees that, except with respect to services performed under this Agreement on behalf of
Employer, <B>Employee shall not</B>, at any time during the Restricted Period (as defined below), for Employee or on behalf of any other person, persons, firm, partnership, corporation or employer, participate or engage in or own an interest in,
directly or indirectly, any individual proprietorship, partnership, corporation, joint venture, trust or other form of business entity, whether as an individual proprietor, partner, joint venturer, officer, director, member, employee, consultant,
independent contractor, stockholder, lender, landlord, finder, agent, broker, trustee, or in any manner whatsoever, if such entity or its affiliates is engaged in, directly or indirectly, &#147;Employer&#146;s Business,&#148; as defined on Exhibit A
hereto. Employee acknowledges that, as of the date hereof, Employee&#146;s responsibilities will include matters affecting the businesses of Employer listed on Exhibit A. For purposes of this Section&nbsp;8, the &#147;Restricted Period&#148; shall
mean the Employment Period plus (i)&nbsp;eighteen (18) months in the event this Agreement is terminated pursuant to Sections 4.1, 4.7(a), 4.7(b), 4.7(d), 4.7(e), or 4.7(f) or (ii)&nbsp;twenty-four (24)&nbsp;months in the event the Agreement is
terminated for any other reason. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.2.&nbsp;&nbsp;&nbsp;&nbsp;<I>No Hire</I>. Employee further agrees that <B>Employee shall
not</B>, at any time during the Employment Period and for a period of eighteen (18)&nbsp;months immediately following termination of this Agreement for any reason, for Employee or on behalf of any other person, persons, firm, partnership,
corporation or employer, employ, or knowingly permit any company or business directly or indirectly controlled by Employee to employ or otherwise engage (a)&nbsp;any person who is a then current employee or independent contractor of Employer or one
of its affiliates, or (b)&nbsp;any person who was an employee or independent contractor of Employer or one of its affiliates in the prior six (6)&nbsp;month period, or in any manner seek to induce such persons to leave his or her employment or
engagement with Employer or one of its affiliates (including without limitation for or on behalf of a subsequent employer of Employee). </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">8.3 <I><FONT STYLE="white-space:nowrap">&nbsp;&nbsp;&nbsp;&nbsp;Non-solicitation.</FONT> </I>Employee further agrees that <B>Employee shall not</B>, at any time during the Employment Period and for a
period of eighteen (18)&nbsp;months immediately following termination of this Agreement for any reason, for Employee or on behalf of any other person, persons, firm, partnership, corporation or employer, solicit or accept business from or take any
action that would interfere with, diminish or impair the valuable relationships that Employer or its affiliates have with (i)&nbsp;hospitals or other health care facilities with which Employer or its affiliates have contracts to render professional
services or otherwise have established relationships, (ii)&nbsp;patients, (iii) referral sources, (iv)&nbsp;vendors, (v) any other clients of Employer or its affiliates, or (vi)&nbsp;prospective hospitals, patients, referral sources, vendors or
clients whose business Employee was aware that Employer or any affiliate of Employer was in the process of soliciting at the time of Employee&#146;s termination (including potential acquisition targets). </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.4.&nbsp;&nbsp;&nbsp;&nbsp;<I>Confidential Information</I>. At all times during the term of this Agreement, Employer shall provide
Employee with access to &#147;Confidential Information.&#148; As used in this Agreement, the term &#147;Confidential Information&#148; means any and all confidential, proprietary or trade secret information, whether disclosed, directly or
indirectly, verbally, in writing or by any other means in tangible or intangible form, including that which is conceived or developed by Employee, applicable to or in any way related to: (i)&nbsp;patients with whom Employer has a physician/patient
relationship; (ii)&nbsp;the present or future business of Employer; or (iii)&nbsp;the research and development of </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">14 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
Employer. Without limiting the generality of the foregoing, Confidential Information includes: (a)&nbsp;the development and operation of Employer&#146;s medical practices, including information
relating to budgeting, staffing needs, marketing, research, hospital relationships, equipment capabilities, and other information concerning such facilities and operations and specifically including the procedures and business plans developed by
Employer for use at the hospitals where Employer conducts its business; (b)&nbsp;contractual arrangements between the Employer and insurers or managed care associations or other payors; (c)&nbsp;the databases of Employer; (d)&nbsp;the clinical and
research protocols of Employer, including coding guidelines; (e)&nbsp;the referral sources of Employer; (f)&nbsp;other confidential information of Employer that is not generally known to the public that gives Employer the opportunity to obtain an
advantage over competitors who do not know or use it, including the names, addresses, telephone numbers or special needs of any of its patients, its patient lists, its marketing methods and related data, lists or other written records used in
Employer&#146;s business, compensation paid to employees and other terms of employment, accounting ledgers and financial statements, contracts and licenses, business systems, business plan and projections, and computer programs. The parties agree
that, as between them, this Confidential Information constitutes important, material, and confidential trade secrets that affect the successful conduct of Employer&#146;s business and its goodwill. Employer acknowledges that the Confidential
Information specifically enumerated above is special and unique information and is not information that would be considered a part of the general knowledge and skill Employee has or might otherwise obtain. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Notwithstanding the foregoing, Confidential Information shall not include any information that (i)&nbsp;was known by Employee from a
third party source before disclosure by or on behalf of Employer, (ii)&nbsp;becomes available to Employee from a source other than Employer that is not, to Employee&#146;s knowledge, bound by a duty of confidentiality to Employer, (iii)&nbsp;becomes
generally available or known in the industry other than as a result of its disclosure by Employee, or (iv)&nbsp;has been independently developed by Employee and may be disclosed by Employee without breach of this Agreement, provided, in each case,
that the Employee shall bear the burden of demonstrating that the information falls under one of the above-described exceptions. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">Employee agrees that the terms of this Agreement shall be deemed Confidential Information for purposes of this Section. Employee shall keep the terms of this Agreement strictly confidential and will not,
without the prior written consent of Employer, disclose the details of this Agreement to any third party in any manner whatsoever in whole or in part, with the exception of Employee&#146;s representatives (such as tax advisors and attorneys) who
need to know such information. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Employee agrees that Employee will not at any time, whether during or subsequent to the term
of Employee&#146;s employment with Employer, in any fashion, form or manner, unless specifically consented to in writing by Employer, either directly or indirectly, use or divulge, disclose, or communicate to any person, firm or corporation, in any
manner whatsoever, any Confidential Information of any kind, nature, or description, subject to applicable law. The parties agree that any breach by Employee of any term of this Section is a material breach of this Agreement and shall constitute
&#147;cause&#148; for the termination of Employee&#146;s employment hereunder. In the event that Employee is ordered to disclose any Confidential Information, whether in a legal or a regulatory proceeding or otherwise, Employee shall provide
Employer with prompt written notice of such request or order so that Employer may seek to prevent disclosure or, if that cannot be achieved, the entry of a protective order or other appropriate protective device or procedure in order to assure, to
</FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">15 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
the extent practicable, compliance with the provisions of this Agreement. In the case of any disclosure required by law, Employee shall disclose only that portion of the Confidential Information
that Employee is ordered to disclose in a legally binding subpoena, demand or similar order issued pursuant to a legal or regulatory proceeding. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT
STYLE="font-family:Times New Roman" SIZE="2">All Confidential Information, and all equipment, notebooks, documents, memoranda, reports, files, samples, books, correspondence, lists, other written and graphic records, in any media (including
electronic or video) containing Confidential Information or relating to the business of Employer, which Employee shall prepare, use, construct, observe, possess, or control shall be and remain Employer&#146;s sole property (collectively
&#147;Employer Property&#148;). Upon termination or expiration of this Agreement, or earlier upon Employer&#146;s request, Employee shall promptly deliver to Employer all Employer Property, retaining none. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.5.&nbsp;&nbsp;&nbsp;&nbsp;<I>Ownership of Work Product.</I> Employee agrees and acknowledges that (i)&nbsp;all copyrights, patents,
trade secrets, trademarks, service marks, or other intellectual property or proprietary rights associated with any ideas, concepts, techniques, inventions, processes, or works of authorship developed or created by Employee during the course of
performing work for Employer and any other work product conceived, created, designed, developed or contributed by Employee during the term of this Agreement that relates in any way to Employer&#146;s Business (collectively, the &#147;Work
Product&#148;), shall belong exclusively to Employer and shall, to the extent possible, be considered a work made for hire within the meaning of Title 17 of the United States Code. To the extent the Work Product may not be considered a work made for
hire owned exclusively by Employer, Employee hereby assigns to Employer all right, title, and interest worldwide in and to such Work Product at the time of its creation, without any requirement of further consideration. Upon request of Employer,
Employee shall take such further actions and execute such further documents as Employer may deem necessary or desirable to further the purposes of this Agreement, including without limitation separate assignments of all right, title, and interest in
and to all rights of copyright and all right, title, and interest in and to any inventions or patents and any reissues or extensions which may be granted therefore, and in and to any improvements, additions to, or modifications thereto, which
Employee may acquire by invention or otherwise, the same to be held and enjoyed by Employer for its own use and benefit, and for the use and benefit of Employer&#146;s successors and assigns, as fully and as entirely as the same might be held by
Employee had this assignment not been made. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.6.&nbsp;&nbsp;&nbsp;&nbsp;<I>Clearance Procedure for Proprietary Rights Not
Claimed by Employer.</I> In the event that Employee wishes to create or develop, <I>other than</I> on Employer&#146;s time or using Employer&#146;s resources, anything that may be considered Work Product but to which Employee believes Employee
should be entitled to the personal benefit of, Employee agrees to follow the clearance procedure set forth in this Section. Before beginning any such work, Employee agrees to give Employer advance written notice and provide Employer with a
sufficiently detailed written description of the work under consideration for Employer to make a determination regarding the work. Unless otherwise agreed in a writing signed by Employer prior to receipt, Employer shall have no obligation of
confidentiality with respect to such request or description. Employer will determine in its sole discretion, within thirty (30)&nbsp;days after Employee has fully disclosed such plans to Employer, whether rights in such work will be claimed by
Employer. If Employer determines that it does not claim rights in such work, Employer agrees to so notify Employee in writing and </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">16 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
Employee may retain ownership of the work to the extent that such work has been expressly disclosed to Employer. If Employer fails to so notify Employee within such thirty (30)&nbsp;day period,
then Employer shall be deemed to have agreed that such work is not considered Work Product for purposes of this Agreement. Employee agrees to submit for further review any significant improvement, modification, or adaptation that could reasonably be
related to Employer&#146;s Business so that it can be determined whether the improvement, modification, or adaptation relates to the business or interests of Employer. Clearance under this procedure does not relieve Employee of the restrictive
covenants set forth in this Section&nbsp;8. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.7.
&nbsp;&nbsp;&nbsp;&nbsp;<I><FONT STYLE="white-space:nowrap">Non-Disparagement.</FONT></I> For a period of ten (10)&nbsp;years after the termination of this Agreement, Employee will not, directly or indirectly, as an individual or on behalf of a
firm, corporation, partnership or other legal entity, make any disparaging or negative comment to any other person or entity regarding Employer or any of its affiliates, agents, attorneys, employees, officers and directors, Employee&#146;s work
conditions or circumstances surrounding Employee&#146;s separation from Employer or otherwise impugn or criticize the name or reputation of Employer, its affiliates, agents, attorneys, employees, officers or directors, orally or in writing.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.8.&nbsp;&nbsp;&nbsp;&nbsp;<I>Review by Employee.</I> <B>Employee has carefully read and considered the terms and provisions
of this Section</B><B></B><B>&nbsp;8, and having done so, agrees that the restrictions set forth in this Section</B><B></B><B>&nbsp;8 are fair and reasonably required for the protection of the interests of Employer.</B> In the event that any term or
provision set forth in this Section&nbsp;8 shall be held to be invalid or unenforceable by a court of competent jurisdiction, the parties hereto agree that such invalid or unenforceable term(s) or provision(s) may be severed from this Agreement
without, in any manner, affecting the remaining portions hereof. Without limiting other possible remedies available to Employer, Employee agrees that injunctive or other equitable relief will be available to enforce the covenants set forth in this
Section, such relief to be without the necessity of posting a bond. In the event that, notwithstanding the foregoing, any part of the covenants set forth in this Section shall be held to be invalid, overbroad, or unenforceable by an arbitration
panel or a court of competent jurisdiction, the parties hereto agree that such invalid, overbroad, or unenforceable provision(s) may be modified or severed from this Agreement without, in any manner, affecting the remaining portions of this
Section&nbsp;8 (all of which shall remain in full force and effect). In the event that any provision of this Section&nbsp;8 related to time period or areas of restriction shall be declared by an arbitration panel or a court of competent jurisdiction
to exceed the maximum time period, area or activities such arbitration panel or court deems reasonable and enforceable, said time period or areas of restriction shall be deemed modified to the minimum extent necessary to make the geographic or
temporal restrictions or activities reasonable and enforceable. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:8%"><FONT STYLE="font-family:Times New Roman" SIZE="2">8.9.&nbsp;&nbsp;&nbsp;&nbsp;<I>Survival.</I> The provisions
of this Section&nbsp;8 shall survive the termination of this Agreement and Employee&#146;s employment with Employer.<B> </B>The provisions of this Section&nbsp;8 shall apply during the time Employee is receiving Disability payments from Employer as
a result of a termination of this Agreement pursuant to Section&nbsp;4.2 hereof.<B> </B>In the event of a breach of this Section&nbsp;8 by Employee, Employer retains the right to terminate any continuing payments to Employee provided for in
Section&nbsp;5 of this Agreement. The provisions of this Section&nbsp;8 are expressly intended to benefit and be enforceable by other affiliated entities of Employer, who are express third party beneficiaries hereof. Employee shall not assist others
in engaging in any of the activities described in the foregoing restrictive covenants. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">17 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>9.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Arbitration. </B>Any controversy or claim arising out of
or relating to this Agreement, or any alleged breach hereof shall be finally determined by binding arbitration before a three member panel, consisting of one member selected by each party hereto, with the third member selected by the first two
arbitrators. Each party hereto shall bear the costs of its own nominee, and shall share equally the cost of the third arbitrator and the parties agree that the costs of arbitration shall not be subject to reapportionment by the arbitration panel.
The arbitration proceedings shall be held in Sunrise, Florida, unless otherwise mutually agreed by the parties, and shall be conducted in accordance with the American Arbitration Association National Rules for the Resolution of Employment Disputes
then in effect. Judgment on the award rendered by the arbitration panel may be entered and enforced by any court having jurisdiction thereof. Notwithstanding anything herein to the contrary, if the Employer shall require immediate injunctive relief,
then the Employer shall be entitled to seek such relief in any court having jurisdiction, and if the Employer elects to do so, the Employee hereby consents to the jurisdiction of the state and federal courts sitting in the State of Florida and to
the applicable service of process. Employee hereby waives and agrees not to assert, to the fullest extent permitted by applicable law, any claim that (i)&nbsp;Employee is not subject to the jurisdiction of such courts, (ii)&nbsp;Employee is immune
from any legal process issued by such courts and (iii)&nbsp;any litigation or other proceeding commenced in such courts is brought in an inconvenient forum. Any such arbitration shall be treated as confidential by all parties thereto, except as
otherwise provided by law or as otherwise necessary to enforce any judgment or order issued by the arbitrators. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>10.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Governing Law.</B> This Agreement shall be governed by and construed in accordance with the laws of
the State of Florida without regard to its conflict of laws principles to the extent that such principles would require the application of laws other than the laws of the State of Florida. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>11.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Notices.</B> Any notice required or permitted to be given under this Agreement shall be in writing
and shall be deemed to have been given when delivered by hand or when deposited in the United States mail by registered or certified mail, return receipt requested, postage prepaid, addressed as follows: </FONT></P>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="90%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE" ALIGN="center">


<TR>
<TD WIDTH="51%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD WIDTH="47%"></TD></TR>


<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">If to Employer:</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">If to Employee:</FONT></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">Mednax Services, Inc.</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">David A. Clark</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">1301 Concord Terrace</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">c/o Mednax Services, Inc.</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">Sunrise, FL 33323</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">1301 Concord Terrace</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">Attention: General Counsel</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">Sunrise, FL 33323</FONT></TD></TR>
</TABLE> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">or to such other addresses as either party hereto may from time to time give notice of to the other in the aforesaid
manner. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>12.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Benefits: Binding Effect.</B> This Agreement shall be for the benefit of and
binding upon the parties hereto and their respective heirs, personal representatives, legal representatives, successors and, where applicable, assigns.&nbsp;&nbsp;&nbsp;&nbsp;Notwithstanding the foregoing, Employee may not assign the rights or
benefits hereunder without the prior written consent of Employer. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">18 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>13.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Severability. </B>The invalidity of any one or more of
the words, phrases, sentences, clauses or sections contained in this Agreement shall not affect the enforceability of the remaining portions of this Agreement or any part thereof, all of which are inserted conditionally on their being valid in law,
and, in the event that any one or more of the words, phrases, sentences, clauses or sections contained in this Agreement shall be declared invalid, this Agreement shall be construed as if such invalid word or words, phrase or phrases, sentence or
sentences, clause or clauses, or section or sections had not been inserted. If such invalidity is caused by length of time or size of area, or both, the otherwise invalid provision will be considered to be reduced to a period or area, which would
cure such invalidity. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>14.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Waivers. </B>The waiver by either party hereto of a breach or
violation of any term or provision of this Agreement shall not operate nor be construed as a waiver of any subsequent breach or violation. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>15.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Damages. </B>Nothing contained herein shall be construed to prevent Employer or Employee from seeking and recovering from the other damages sustained by either or both
of them as a result of a breach of any term or provision of this Agreement. In the event that either party hereto brings suit for the collection of any damages resulting from, or the injunction of any action constituting, a breach of any of the
terms or provisions of this Agreement, then the party found to be at fault shall pay all reasonable court costs and attorneys&#146; fees of the other, whether such costs and fees are incurred in a court of original jurisdiction or one or more courts
of appellate jurisdiction. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>16.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>No Third Party Beneficiary. </B>Except as provided in
Section&nbsp;8.9, nothing expressed or implied in this Agreement is intended, or shall be construed, to confer upon or give any person (other than the parties hereto and, in the case of Employee, Employee&#146;s heirs, personal representative(s)
and/or legal representative) any rights or remedies under or by reason of this Agreement. No agreements or representations, oral or otherwise, express or implied, have been made by either party with respect to the subject matter of this Agreement
which agreements or representations are not set forth expressly in this Agreement, and this Agreement supersedes any other employment agreement between Employer and Employee. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>17.</B>&nbsp;&nbsp;&nbsp;&nbsp;<B>Assignment.</B> This Agreement may be assigned by Employer upon notice to Employee. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><I>The remainder of this page has been left blank intentionally. </I></FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">19 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>IN WITNESS WHEREOF</B>, the undersigned have executed this Agreement this 12th day of
February, 2018, effective as of the Effective Date. </FONT></P> <P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE">


<TR>
<TD WIDTH="2%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="44%"></TD>
<TD VALIGN="bottom"></TD>
<TD WIDTH="4%"></TD>
<TD VALIGN="bottom"></TD>
<TD WIDTH="2%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="44%"></TD></TR>


<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>EMPLOYER:</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom" COLSPAN="3"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>EMPLOYEE:</B></FONT></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>MEDNAX SERVICES, INC.</B></FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">By:</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"> <P STYLE="margin-top:0px;margin-bottom:1px;border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="2">/s/ Manuel Kadre</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">By:</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"> <P STYLE="margin-top:0px;margin-bottom:1px;border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="2">/s/ David A. Clark</FONT></P></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">Manuel Kadre</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">David A. Clark</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"><FONT STYLE="font-family:Times New Roman" SIZE="2">Chairman, Compensation Committee</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"></TD></TR>
</TABLE>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">20 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>EXHIBIT A </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>BUSINESS OF EMPLOYER </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">As of the date hereof, Employer, directly or through
its affiliates, provides professional medical services and all aspects of practice management services in medical practice areas that include, but are not limited to, the following (collectively referred to herein as &#147;Employer&#146;s
Business&#148;): </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(1) Neonatology, including hospital well baby care; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(2) Maternal-Fetal Medicine, including general obstetrics services; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(3) Pediatric Cardiology;
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(4) Pediatric Intensive Care, including Pediatric Hospitalist Care; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT
STYLE="font-family:Times New Roman" SIZE="2">(5) Newborn hearing screening services; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(6) Pediatric Surgery; </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(7) Pediatric Emergency Medicine; </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(8)
Anesthesiology, critical care medicine and pain management; and </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">(9) Radiology and Teleradiology. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">References to Employer&#146;s Business in this Agreement shall include such other medical service lines, practice management services and
other businesses in which Employer is engaged during the Employment Period; <I>provided,</I> that to be considered a part of Employer&#146;s Business, Employer must have engaged in such other service line, practice management service or other
business at least six (6)&nbsp;months prior to the termination date of this Agreement. For purposes of this Exhibit A, businesses of Employer shall include the businesses conducted by Employer&#146;s subsidiaries, entities under common control and
affiliates as defined under Rule 144 of the Securities Act of 1933, as amended. Such affiliates shall include the professional corporations and associations whose operating results are consolidated with Employer for financial reporting purposes.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">Notwithstanding the foregoing, Employer acknowledges and agrees to the following exceptions and clarifications regarding the
scope of Employer&#146;s Business. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">A.&nbsp;&nbsp;&nbsp;&nbsp;<I>Hospital Services. </I>Employer and Employee acknowledge
that, as of the date hereof, Employer does not currently operate hospitals, hospital systems or universities. Nevertheless, the businesses of hospitals, hospital systems and universities would be the same as Employer&#146;s Business where such
hospitals, hospital systems or universities provide or contract with others to provide some or all of the medical services included in Employer&#146;s Business. Therefore, the parties desire to clarify their intent with respect to the limitations on
Employee&#146;s ability to work for or contract with others to provide services for a hospital, hospital system or university during the Employment Period and during the Restricted Period. Section&nbsp;8.1 shall not be deemed to restrict
Employee&#146;s ability to work for a hospital, hospital system or university if the hospital, hospital system or university does not provide any of the medical services included in Employer&#146;s Business. Furthermore, even if a hospital, hospital
system or university provides medical services that are included in Employer&#146;s Business, Employee may work for such hospital, hospital system or university if Employee has no direct supervisory responsibility for or involvement in the
hospital&#146;s, </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">21 </FONT></P>



<p Style='page-break-before:always'>
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 <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">
hospital system&#146;s or university&#146;s medical services that are Employer&#146;s Business. Finally, Employer agrees that Employee may hold direct supervisory responsibility for or be
involved in the medical services of a hospital, hospital system or university that are included in Employer&#146;s Business so long as such hospital, hospital system or university is located at least ten (10)&nbsp;miles from a medical practice owned
or operated by Employer or its affiliate. Subject to paragraph B below, the provisions of this paragraph shall not apply to the extent that, after the date hereof, Employer enters into the business of operating a hospital or hospital system.
</FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">B.&nbsp;&nbsp;&nbsp;&nbsp;<I>De Minimus Exception. </I>Employer agrees that a medical service line (other than those listed
in items 1 through 9 above), practice management service or other business in which Employer is engaged shall not be considered to be a part of Employer&#146;s Business if such medical service line, practice management service or other business
constitutes less than Fifteen Million Dollars ($15,000,000) of Employer&#146;s annual revenues. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">C.&nbsp;&nbsp;&nbsp;&nbsp;<I>Certain Ownership Interests. </I><B></B>It shall not be deemed to be a violation of Section&nbsp;8.1 for
Employee to: (i)&nbsp;own, directly or indirectly, one percent (1%) or less of a publicly-traded entity; or (ii)&nbsp;own, directly or indirectly, less than five percent (5%) of a privately-held business or company, if Employee is at all times a
passive investor with no board representation, management authority or other special rights to control operations of such business or company.<I> </I> </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">22 </FONT></P>



<p Style='page-break-before:always'>
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 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>EXHIBIT B </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>COMPENSATION </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Performance Bonus:</B> Up to One Hundred Percent (100%) of
Employee&#146;s Base Salary </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Equity Compensation: </B>Employee shall be eligible for equity compensation as approved by the Compensation
Committee of the Board of Directors. </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">23 </FONT></P>



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 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>EXHIBIT C </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>FORM OF RELEASE </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B><I>GENERAL RELEASE OF CLAIMS </I></B></FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">1.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
(&#147;<U>Employee</U>&#148;), for himself and his family, heirs, executors, administrators, legal representatives and their respective successors and assigns, in exchange for the consideration received pursuant to
Section&nbsp;5.[&nbsp;&nbsp;&nbsp;&nbsp;] of the Employment Agreement to which this release is attached as Exhibit C (the &#147;<U>Employment Agreement</U>&#148;), does hereby release and forever discharge
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (&#147;<U>Employer</U>&#148;), its subsidiaries, affiliated companies, successors and assigns, and its current or former
directors, officers, employees, shareholders or agents in such capacities (collectively with Employer, the &#147;<U>Released Parties</U>&#148;) from any and all actions, causes of action, suits, controversies, claims and demands whatsoever, for or
by reason of any matter, cause or thing whatsoever, whether known or unknown including, but not limited to, all claims under any applicable laws arising under or in connection with Employee&#146;s employment or termination thereof, whether for
discrimination, harassment, retaliation, tort, breach of express or implied employment contract, wrongful discharge, intentional infliction of emotional distress, or defamation or injuries incurred on the job or incurred as a result of loss of
employment. Employee acknowledges that Employer encouraged him to consult with an attorney of his choosing, and through this General Release of Claims encourages Employee to consult with his attorney with respect to possible claims under the Age
Discrimination in Employment Act (&#147;<U>ADEA</U>&#148;) and that he understands that the ADEA is a Federal statute that, among other things, prohibits discrimination on the basis of age in employment and employee benefits and benefit plans.
Without limiting the generality of the release provided above, Employee expressly waives any and all claims under ADEA that he may have as of the date hereof. Employee further understands that by signing this General Release of Claims he is in fact
waiving, releasing and forever giving up any claim under the ADEA as well as all other laws within the scope of this paragraph 1 that may have existed on or prior to the date hereof. Notwithstanding anything in this paragraph 1 to the contrary, this
General Release of Claims shall not apply to (i)&nbsp;any actions to enforce rights to receive any payments or benefits which may be due Employee pursuant to Section&nbsp;5.[&nbsp;&nbsp;&nbsp;&nbsp;] of the Employment Agreement, or under any of
Employer&#146;s employee benefit plans, (ii)&nbsp;any rights or claims that may arise as a result of events occurring after the date this General Release of Claims is executed, (iii)&nbsp;any indemnification rights Employee may have as a former
officer or director of Employer or its subsidiaries or affiliated companies, (iv)&nbsp;any claims for benefits under any directors&#146; and officers&#146; liability policy maintained by Employer or its subsidiaries or affiliated companies in
accordance with the terms of such policy, and (v)&nbsp;any rights as a holder of equity securities of Employer. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.&nbsp;&nbsp;&nbsp;&nbsp;Employee represents that he has not filed against the Released Parties any complaints, charges, or lawsuits
arising out of his employment, or any other matter arising on or prior to the date of this General Release of Claims, and covenants and agrees that he will never individually or with any person file, or commence the filing of, any charges, lawsuits,
complaints or proceedings with any governmental agency, or against the Released Parties with respect to any of the matters released by Employee pursuant to paragraph 1 hereof (a &#147;<U>Proceeding</U>&#148;). </FONT></P>
 <p STYLE="margin-top:0px;margin-bottom:0px"><FONT SIZE="1">&nbsp;</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2">24 </FONT></P>



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 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">3.&nbsp;&nbsp;&nbsp;&nbsp;Notwithstanding anything in this Agreement to the contrary, nothing in
this Agreement or any other agreement between Employer and Employee shall prevent Employee from filing a charge, sharing information and communicating in good faith, without prior notice to the Company, with any federal government agency having
jurisdiction over the Company or its operations, and cooperating in any investigation by any such federal government agency; However, to the maximum extent permitted by law, Employee agrees that if such an administrative claim is made, Employee
shall not be entitled to recover any individual monetary relief or other individual remedies. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">4.&nbsp;&nbsp;&nbsp;&nbsp;Employee hereby
acknowledges that Employer has informed him that he has up to <FONT STYLE="white-space:nowrap">twenty-one</FONT> (21)&nbsp;days to sign this General Release of Claims and he may knowingly and voluntarily waive that
<FONT STYLE="white-space:nowrap">twenty-one</FONT> (21)&nbsp;day period by signing this General Release of Claims earlier. Employee also understands that he shall have seven (7)&nbsp;days following the date on which he signs this General Release of
Claims within which to revoke it by providing a written notice of his revocation to Employer. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">5.&nbsp;&nbsp;&nbsp;&nbsp;Employee
acknowledges that this General Release of Claims will be governed by and construed and enforced in accordance with the internal laws of the State of Florida applicable to contracts made and to be performed entirely within such State. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">6.&nbsp;&nbsp;&nbsp;&nbsp;Employee acknowledges that he has read this General Release of Claims, that he has been advised that he should
consult with an attorney before he executes this general release of claims, and that he understands all of its terms and executes it voluntarily and with full knowledge of its significance and the consequences thereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">7.&nbsp;&nbsp;&nbsp;&nbsp;This General Release of Claims shall take effect on the eighth day following Employee&#146;s execution of this
General Release of Claims unless Employee&#146;s written revocation is delivered to Employer within seven (7)&nbsp;days after such execution. </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P><DIV ALIGN="right">
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="40%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


<TR>
<TD WIDTH="100%"></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">&nbsp;</P></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"><U>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</U>, 20<U>&nbsp;&nbsp;&nbsp;&nbsp;</U></TD></TR>
</TABLE></DIV>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">25 </P>

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</DOCUMENT>
<DOCUMENT>
<TYPE>EX-21.1
<SEQUENCE>7
<FILENAME>d463027dex211.htm
<DESCRIPTION>EX-21.1
<TEXT>
<HTML><HEAD>
<TITLE>EX-21.1</TITLE>
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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="right"><B>Exhibit 21.1 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Subsidiaries </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="92%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="61%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom" ROWSPAN="2" NOWRAP><B>Name of Subsidiary</B></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ROWSPAN="2" ALIGN="center"><B>State of<BR>Incorporation</B></TD>
<TD VALIGN="bottom" ROWSPAN="2">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ROWSPAN="2" ALIGN="center"><B>Line of<BR>Business</B></TD>
<TD VALIGN="bottom" ROWSPAN="2">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center"><B>Number of Omitted<BR>Subsidiaries&nbsp;Operating</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center"><B>in the<BR>United<BR>States</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>in</B></P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>Foreign<BR>Countries</B></P></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Mednax Services, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top" ALIGN="right">Florida</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;<BR></TD>
<TD VALIGN="bottom" ALIGN="right">Physician<BR>Services</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;<BR>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">15</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Pediatrix Medical Group, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top" ALIGN="right">Florida</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;<BR></TD>
<TD VALIGN="bottom" ALIGN="right">Physician<BR>Services</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;<BR>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">10</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">American Anesthesiology, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top" ALIGN="right">Florida</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;<BR></TD>
<TD VALIGN="bottom" ALIGN="right">Physician<BR>Services</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;<BR>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">9</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
</TABLE>
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<DOCUMENT>
<TYPE>EX-23.1
<SEQUENCE>8
<FILENAME>d463027dex231.htm
<DESCRIPTION>EX-23.1
<TEXT>
<HTML><HEAD>
<TITLE>EX-23.1</TITLE>
</HEAD>
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 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Exhibit 23.1 </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">We hereby consent to the
incorporation by reference in the Registration Statements on Form <FONT STYLE="white-space:nowrap">S-8</FONT> (Nos. <FONT STYLE="white-space:nowrap">333-181667,</FONT> <FONT STYLE="white-space:nowrap">333-153397,</FONT> <FONT
STYLE="white-space:nowrap">333-151272,</FONT> <FONT STYLE="white-space:nowrap">333-121125,</FONT> <FONT STYLE="white-space:nowrap">333-101225,</FONT> <FONT STYLE="white-space:nowrap">333-85366,</FONT> and
<FONT STYLE="white-space:nowrap">333-208698)</FONT> of MEDNAX, Inc. and its subsidiaries of our report dated February&nbsp;14, 2018 relating to the financial statements and the effectiveness of internal control over financial reporting, which
appears in the Annual Report to Shareholders, which is incorporated in this Annual Report on Form <FONT STYLE="white-space:nowrap">10-K.</FONT> We also consent to the incorporation by reference of our report dated February&nbsp;14, 2018 relating to
the financial statement schedule, which appears in this Form <FONT STYLE="white-space:nowrap">10-K.</FONT> </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">/s/ Pricewaterhouse Coopers LLP
</FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">Certified Public Accountants </FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">Miami,
Florida </FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">February&nbsp;14, 2018 </FONT></P>
</BODY></HTML>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-31.1
<SEQUENCE>9
<FILENAME>d463027dex311.htm
<DESCRIPTION>EX-31.1
<TEXT>
<HTML><HEAD>
<TITLE>EX-31.1</TITLE>
</HEAD>
 <BODY BGCOLOR="WHITE">


 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Exhibit 31.1 </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B><U>CERTIFICATIONS </U></B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">I, Roger J. Medel, M.D., certify that: </FONT></P>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">1.</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">I have reviewed this annual report on Form <FONT STYLE="white-space:nowrap">10-K</FONT> of MEDNAX, Inc.; </FONT></TD></TR></TABLE>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in
light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report; </FONT></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial
condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report; </FONT></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">The registrant&#146;s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act
Rules <FONT STYLE="white-space:nowrap">13a-15(e)</FONT> and <FONT STYLE="white-space:nowrap">15d-15(e))</FONT> and internal control over financial reporting (as defined in Exchange Act Rules <FONT STYLE="white-space:nowrap">13a-15(f)</FONT> and <FONT
STYLE="white-space:nowrap">15d-15(f))</FONT> for the registrant and have: </FONT></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a)</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material
information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared; </FONT></TD></TR></TABLE>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">(b)</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide
reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles; </FONT></TD></TR></TABLE>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">(c)</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Evaluated the effectiveness of the registrant&#146;s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the
disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and </FONT></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">(d)</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Disclosed in this report any change in the registrant&#146;s internal control over financial reporting that occurred during the registrant&#146;s most recent fiscal
quarter (the registrant&#146;s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant&#146;s internal control over financial reporting; and
</FONT></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">The registrant&#146;s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the
registrant&#146;s auditors and the audit committee of the registrant&#146;s board of directors (or persons performing the equivalent functions): </FONT></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a)</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely
affect the registrant&#146;s ability to record, process, summarize and report financial information; and </FONT></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">(b)</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant&#146;s internal control over financial
reporting. </FONT></TD></TR></TABLE> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">Date: February&nbsp;14, 2018 </FONT></P>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P><DIV ALIGN="right">
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="40%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE">


<TR>
<TD WIDTH="6%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD WIDTH="92%"></TD></TR>


<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">By:</FONT></P></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="top"> <P STYLE="margin-top:0px;margin-bottom:1px;border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="2">/s/ Roger J. Medel, M.D.</FONT></P></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Roger J. Medel, M.D.</FONT></P></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">Chief Executive Officer</FONT></P></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">(Principal Executive Officer)</FONT></P></TD></TR>
</TABLE></DIV>
</BODY></HTML>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-31.2
<SEQUENCE>10
<FILENAME>d463027dex312.htm
<DESCRIPTION>EX-31.2
<TEXT>
<HTML><HEAD>
<TITLE>EX-31.2</TITLE>
</HEAD>
 <BODY BGCOLOR="WHITE">


 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Exhibit 31.2 </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B><U>CERTIFICATIONS </U></B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">I, Vivian Lopez-Blanco, certify that: </FONT></P>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">1.</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">I have reviewed this annual report on Form <FONT STYLE="white-space:nowrap">10-K</FONT> of MEDNAX, Inc.; </FONT></TD></TR></TABLE>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">2.</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in
light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report; </FONT></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">3.</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial
condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report; </FONT></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">4.</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">The registrant&#146;s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act
Rules <FONT STYLE="white-space:nowrap">13a-15(e)</FONT> and <FONT STYLE="white-space:nowrap">15d-15(e))</FONT> and internal control over financial reporting (as defined in Exchange Act Rules <FONT STYLE="white-space:nowrap">13a-15(f)</FONT> and <FONT
STYLE="white-space:nowrap">15d-15(f))</FONT> for the registrant and have: </FONT></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a)</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material
information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared; </FONT></TD></TR></TABLE>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">(b)</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide
reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles; </FONT></TD></TR></TABLE>
<P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">(c)</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Evaluated the effectiveness of the registrant&#146;s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the
disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and </FONT></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">(d)</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Disclosed in this report any change in the registrant&#146;s internal control over financial reporting that occurred during the registrant&#146;s most recent fiscal
quarter (the registrant&#146;s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant&#146;s internal control over financial reporting; and
</FONT></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">5.</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">The registrant&#146;s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the
registrant&#146;s auditors and the audit committee of the registrant&#146;s board of directors (or persons performing the equivalent functions): </FONT></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">(a)</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely
affect the registrant&#146;s ability to record, process, summarize and report financial information; and </FONT></TD></TR></TABLE> <P STYLE="font-size:6px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left"><FONT STYLE="font-family:Times New Roman" SIZE="2">(b)</FONT></TD>
<TD ALIGN="left" VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant&#146;s internal control over financial
reporting. </FONT></TD></TR></TABLE> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">Date: February&nbsp;14, 2018 </FONT></P>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P><DIV ALIGN="right">
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="40%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE">


<TR>
<TD WIDTH="6%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD WIDTH="92%"></TD></TR>


<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">By:</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"> <P STYLE="margin-top:0px;margin-bottom:1px;border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="2">/s/ Vivian Lopez-Blanco</FONT></P></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"><FONT STYLE="font-family:Times New Roman" SIZE="2">Vivian Lopez-Blanco</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"><FONT STYLE="font-family:Times New Roman" SIZE="2">Chief Financial Officer and Treasurer</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">(Principal Financial Officer)</FONT></P></TD></TR>
</TABLE></DIV>
</BODY></HTML>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-32
<SEQUENCE>11
<FILENAME>d463027dex32.htm
<DESCRIPTION>EX-32
<TEXT>
<HTML><HEAD>
<TITLE>EX-32</TITLE>
</HEAD>
 <BODY BGCOLOR="WHITE">


 <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="right"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>Exhibit 32 </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px" ALIGN="center"><FONT
STYLE="font-family:Times New Roman" SIZE="2"><B>Certification Pursuant to 18 U.S.C Section 1350 </B></FONT></P> <P STYLE="margin-top:0px;margin-bottom:0px" ALIGN="center"><FONT STYLE="font-family:Times New Roman" SIZE="2"><B>(Adopted by Section 906
of the Sarbanes-Oxley Act of 2002) </B></FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">In connection with the Annual Report of MEDNAX, Inc. on Form 10-K for the year ended
December 31, 2017 (the &#147;Report&#148;), each of the undersigned hereby certifies, pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that (i) the Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities
Exchange Act of 1934 and (ii) the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of MEDNAX, Inc. </FONT></P>
<P STYLE="margin-top:12px;margin-bottom:0px; text-indent:4%"><FONT STYLE="font-family:Times New Roman" SIZE="2">A signed original of this written statement required by Section 906 has been provided to MEDNAX, Inc. and will be retained by MEDNAX,
Inc. and furnished to the Securities and Exchange Commission or its staff upon request. </FONT></P> <P STYLE="margin-top:12px;margin-bottom:0px"><FONT STYLE="font-family:Times New Roman" SIZE="2">February 14, 2018 </FONT></P>
<P STYLE="font-size:12px;margin-top:0px;margin-bottom:0px">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="40%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE">


<TR>
<TD WIDTH="7%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="92%"></TD></TR>


<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">By:</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"> <P STYLE="margin-top:0px;margin-bottom:1px;border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="2">/s/ Roger J. Medel, M.D.</FONT></P></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"><FONT STYLE="font-family:Times New Roman" SIZE="2">Roger J. Medel, M.D.</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"><FONT STYLE="font-family:Times New Roman" SIZE="2">Chief Executive Officer</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"><FONT STYLE="font-family:Times New Roman" SIZE="2">(Principal Executive Officer)</FONT></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top"><FONT STYLE="font-family:Times New Roman" SIZE="2">By:</FONT></TD>
<TD VALIGN="bottom"><FONT SIZE="1">&nbsp;</FONT></TD>
<TD VALIGN="bottom"> <P STYLE="margin-top:0px;margin-bottom:1px;border-bottom:1px solid #000000"><FONT STYLE="font-family:Times New Roman" SIZE="2">/s/ Vivian Lopez-Blanco</FONT></P></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"><FONT STYLE="font-family:Times New Roman" SIZE="2">Vivian Lopez-Blanco</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"><FONT STYLE="font-family:Times New Roman" SIZE="2">Chief Financial Officer and Treasurer</FONT></TD></TR>
<TR STYLE="page-break-inside:avoid">
<TD VALIGN="top" COLSPAN="3"> <P STYLE="margin-left:1.00em; text-indent:-1.00em"><FONT STYLE="font-family:Times New Roman" SIZE="2">(Principal Financial Officer)</FONT></P></TD></TR>
</TABLE>
</BODY></HTML>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-101.INS
<SEQUENCE>12
<FILENAME>md-20171231.xml
<DESCRIPTION>XBRL INSTANCE DOCUMENT
<TEXT>
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  <dei:AmendmentFlag contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_0AA7986C-2BB9-40B6-8A69-28C8034B5E4C_1_1">false</dei:AmendmentFlag>
  <us-gaap:AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_EE19C523-6B6E-4DF1-8E5F-5E992D154BE1_1_0">&lt;div&gt;
 &lt;p style="margin-top:0px;margin-bottom:0px"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&lt;b&gt;8.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Accounts Payable and Accrued
 Expenses:&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="margin-top:6px;margin-bottom:0px; text-indent:4%"&gt;
 &lt;font style="font-family:Times New Roman" size="2"&gt;Accounts payable
 and accrued expenses consist of the following (in
 thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="font-size:12px;margin-top:0px;margin-bottom:0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table cellspacing="0" cellpadding="0" width="76%" border="0" style="BORDER-COLLAPSE:COLLAPSE" align="center"&gt;
 &lt;tr&gt;
 &lt;td width="70%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="6" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Accounts payable&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;34,632&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;28,474&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Accrued salaries and
 bonuses&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;225,429&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;220,635&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Accrued payroll taxes and
 benefits&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;75,672&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;67,830&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Accrued professional
 liabilities&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;37,912&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;28,972&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Accrued contingent
 consideration&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;6,259&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;6,566&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Accrued interest&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;4,495&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;4,511&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Other accrued
 expenses&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;53,618&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;50,950&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;438,017&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;407,938&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock>
  <us-gaap:AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="INF" id="id_12960622_826F5FF2-24AC-47A7-8172-69D6989CB4C0_1_2">0</us-gaap:AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation>
  <us-gaap:AllocatedShareBasedCompensationExpense contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_D9E0A123-E596-4C3E-B669-51C4092727C8_1_0">29600000</us-gaap:AllocatedShareBasedCompensationExpense>
  <us-gaap:AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="shares" decimals="-3" id="id_12960622_B39A4D88-4B0F-4B52-9D25-83B0A6E7727C_1_3">107000</us-gaap:AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount>
  <us-gaap:AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_BCB9E1E3-3F93-4849-BF44-77A2BE1613E8_9006_900043">29573000</us-gaap:AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue>
  <us-gaap:AmortizationOfFinancingCostsAndDiscounts contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_4">5514000</us-gaap:AmortizationOfFinancingCostsAndDiscounts>
  <us-gaap:AmortizationOfIntangibleAssets contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_C67011C6-E3E7-4A11-AD06-2E94DD0B8455_1_0">68900000</us-gaap:AmortizationOfIntangibleAssets>
  <us-gaap:BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="shares" decimals="INF" id="id_12960622_F1BA568E-3FEF-47ED-A02C-5A326FA27ADA_1_0">69014</us-gaap:BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued>
  <us-gaap:BusinessCombinationsPolicy contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_2354C59F-CFB8-4AD1-B5F8-6C84BE46B364_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Business
 Acquisitions&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 accounts for all business acquisitions at fair value and expenses
 acquisition costs as they are incurred. Any identifiable assets
 acquired and liabilities assumed are recognized and measured at
 their respective fair values on the acquisition date. If
 information about facts and circumstances existing as of the
 acquisition date is incomplete at the end of the reporting period
 in which a business acquisition occurs, the Company will report
 provisional amounts for the items for which the accounting is
 incomplete. The measurement period ends once the Company receives
 sufficient information to finalize the fair values; however, the
 period will not exceed one year from the acquisition date. Prior to
 January&amp;#xA0;1, 2016, any material adjustments recognized during
 the measurement period were required to be reflected
 retrospectively in the Consolidated Financial Statements of the
 subsequent period. Beginning on January&amp;#xA0;1, 2016, any
 adjustments to provisional amounts that are identified during the
 measurement period are required to be recognized in the reporting
 period in which the adjustment amounts are determined.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In connection
 with certain acquisitions, the Company enters into agreements to
 pay additional amounts in cash or common stock based on the
 achievement of certain performance measures for up to five years
 ending after the acquisition dates. The Company measures this
 contingent consideration at fair value at the acquisition date and
 records such contingent consideration as a liability or equity on
 the Company&amp;#x2019;s Consolidated Balance Sheets on the acquisition
 date. The fair value of each contingent consideration liability is
 remeasured at each reporting period with any change in fair value
 recognized as income or expense within operations in the
 Company&amp;#x2019;s Consolidated Statements of Income. See Note 6 for
 more information on the Company&amp;#x2019;s business
 acquisitions.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:BusinessCombinationsPolicy>
  <us-gaap:BusinessCombinationContingentConsiderationArrangementsDescription contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_F5250E6F-0D73-4C12-BA4A-24C072723442_1_1">The contingent consideration of $18.6 million recorded during the year ended December 31, 2017 is related to an agreement to pay an additional cash amount based on the achievement of certain performance measures for the period through June 1, 2019.</us-gaap:BusinessCombinationContingentConsiderationArrangementsDescription>
  <us-gaap:CapitalExpendituresIncurredButNotYetPaid contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_47">2700000</us-gaap:CapitalExpendituresIncurredButNotYetPaid>
  <us-gaap:CapitalLeaseObligationsIncurred contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_46">684000</us-gaap:CapitalLeaseObligationsIncurred>
  <us-gaap:BusinessCombinationConsiderationTransferred1 contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_C795A629-E311-4179-965D-2E2D3C59C2DD_1_6">554000000</us-gaap:BusinessCombinationConsiderationTransferred1>
  <us-gaap:BusinessCombinationDisclosureTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_3A8856E1-F065-4733-BC21-F0972986FFC9_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;6.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Business
 Acquisitions:&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;During the year
 ended December&amp;#xA0;31, 2017, the Company completed 10 physician
 group practice acquisitions, including four radiology practices,
 two maternal-fetal medicine practices, one neonatology practice,
 one pediatric multi-specialty practice and two other pediatric
 subspecialty practices. The acquisition-date fair value of the
 total consideration for the 10 acquisitions was
 $554.0&amp;#xA0;million, net of cash acquired. Approximately
 $531.7&amp;#xA0;million was paid in cash, $2.7&amp;#xA0;million was paid by
 issuing 69,014 shares of the Company&amp;#x2019;s common stock,
 $18.6&amp;#xA0;million was recorded as a contingent consideration
 liability and $1.0&amp;#xA0;million was recorded as accrued purchase
 consideration within other current liabilities.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;These
 acquisitions expanded the Company&amp;#x2019;s national network of
 physician practices. The Company expects to improve the results of
 physician practices through improved managed care contracting,
 improved collections and identification of growth initiatives, as
 well as operating and cost savings based on the significant
 infrastructure it has developed. With respect to the
 Company&amp;#x2019;s acquisition of radiology physician practices, the
 Company believes that it brings a unique value proposition to
 radiology physician groups, in that the Company can provide not
 only practice support, but also teleradiology capabilities that can
 enhance a physician group&amp;#x2019;s efficiency, provide subspecialty
 access and help them grow, remain competitive and meet the ever
 increasing demands of their hospital partners, payors and
 regulatory bodies. In addition, the Company believes that radiology
 physician group practice physicians can complement the staffing
 needs for its teleradiology services business during certain times,
 such as nights and weekends, when such physicians are not providing
 services at their practices.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The 69,014
 shares of the Company&amp;#x2019;s common stock issued as a component of
 the purchase consideration for acquisitions completed during the
 first quarter and fourth quarter of 2017 had an acquisition-date
 fair value of $2.7&amp;#xA0;million. The fair value of such shares was
 determined using the closing price on the New York Stock Exchange
 of the Company&amp;#x2019;s common stock less a discount for lack of
 marketability on the respective dates of acquisition, reflecting a
 three year contractual restriction on the disposition or assignment
 of such common stock.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The
 Company&amp;#x2019;s preliminary allocation of purchase price is as
 follows (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="68%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="83%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Current assets&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;43,550&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Property and
 equipment&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;5,281&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Other noncurrent
 assets&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;52,611&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Goodwill&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;439,822&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Other intangible
 assets&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;39,414&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Current
 liabilities&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(5,674&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Other long-term
 liabilities&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(21,086&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;553,918&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company has
 recorded provisional amounts for deferred income taxes related to
 certain acquisitions completed during the year ended
 December&amp;#xA0;31, 2017. Any adjustments will be recorded during the
 measurement period and are not expected to be material.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Current assets
 acquired and other noncurrent assets acquired include assets with a
 fair value of $23.5&amp;#xA0;million and $22.5&amp;#xA0;million,
 respectively, that are expected to be sold and contributed to a
 joint venture for an equity method investment in that joint
 venture, respectively, within the next twelve months. Accordingly,
 these assets are classified as held for sale.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The contingent
 consideration of $18.6&amp;#xA0;million recorded during the year ended
 December&amp;#xA0;31, 2017 is related to an agreement to pay an
 additional cash amount based on the achievement of certain
 performance measures for the period through June&amp;#xA0;1, 2019. The
 accrued contingent consideration was recorded as a liability at
 acquisition-date fair value using the income approach with assumed
 discount rates ranging from 4.0% to 4.75% over the applicable terms
 and an assumed payment probability assessment over the applicable
 years. The range of the undiscounted amount the Company could pay
 under the contingent consideration agreement is between $0 and
 $20.0&amp;#xA0;million. In connection with this contingent
 consideration arrangement, the Company has designated
 $20.0&amp;#xA0;million as restricted cash in its Consolidated Balance
 Sheet. In addition, during the year ended December&amp;#xA0;31, 2017,
 the Company paid $6.2&amp;#xA0;million for contingent consideration
 related to certain prior-period acquisitions, of which all but the
 accretion recorded during 2017 was accrued as of December&amp;#xA0;31,
 2016.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In connection
 with certain prior period acquisitions, the Company recorded an
 increase in deferred tax liabilities of $0.5&amp;#xA0;million with a
 corresponding increase in goodwill of $0.5&amp;#xA0;million resulting
 from the finalization of income tax acquisition
 accounting.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;During the year
 ended December&amp;#xA0;31, 2016, the Company completed 15
 acquisitions, of which 13 were physician group practices including
 eight anesthesiology practices, two other pediatric subspecialty
 practices, one neonatology practice, one maternal-fetal medicine
 practice and one pediatric cardiology practice. In addition, the
 Company acquired a third-party receivables company and a patient
 engagement software company as additions to its existing management
 services organization. The total consideration for the 15
 acquisitions was $759.6&amp;#xA0;million, net of $15.0&amp;#xA0;million
 cash acquired, of which $756.1&amp;#xA0;million was paid in cash and
 $3.5&amp;#xA0;million was recorded as a contingent consideration
 liability.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;On
 March&amp;#xA0;31, 2017, the Company sold its 75% economic interest in
 a joint venture that was previously consolidated. The
 deconsolidation and removal of 100% of the carrying value of the
 joint venture&amp;#x2019;s net assets resulted in a gain on sale that
 was not material.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:BusinessCombinationDisclosureTextBlock>
  <us-gaap:ConsolidationPolicyTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_0568726E-F2D6-4AD1-A0F4-64BFBC0C5726_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt"&gt;
 &lt;b&gt;Principles of Presentation&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 The consolidated financial statements include all the accounts of
 the Company and its subsidiaries combined with the accounts of the
 affiliated professional contractors with which the Company
 currently has specific management arrangements. The Company&amp;#x2019;s
 agreements with affiliated professional contractors provide that
 the term of the arrangements are in most cases permanent, subject
 only to termination by the Company, except in the case of gross
 negligence, fraud or bankruptcy of the Company. The Company has the
 right to receive income, both as ongoing fees and as proceeds from
 the sale of its interest in the Company&amp;#x2019;s affiliated
 professional contractors, in an amount that fluctuates based on the
 performance of the affiliated professional contractors and the
 change in the fair value of the Company&amp;#x2019;s interest in the
 affiliated professional contractors. The Company has exclusive
 responsibility for the provision of all &lt;font style="WHITE-SPACE: nowrap"&gt;non-medical&lt;/font&gt; services required for the
 &lt;font style="WHITE-SPACE: nowrap"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;day-to-day&lt;/font&gt;&lt;/font&gt; operation and
 management of the Company&amp;#x2019;s affiliated professional
 contractors and establishes the guidelines for the employment and
 compensation of the physicians. In addition, the agreements provide
 that the Company has the right, but not the obligation, to
 purchase, or to designate a person(s) to purchase, the stock of the
 Company&amp;#x2019;s affiliated professional contractors for a nominal
 amount. Separately, in its sole discretion, the Company has the
 right to assign its interest in the agreements. Based upon the
 provisions of these agreements, the Company has determined that the
 affiliated professional contractors are variable interest entities
 and that the Company is the primary beneficiary as defined in the
 accounting guidance for consolidation. All significant intercompany
 and interaffiliate accounts and transactions have been
 eliminated.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 The Company is a partner in a joint venture in which it owns a
 37.5% economic interest. The Company accounts for this joint
 venture under the equity method of accounting because the Company
 exercises significant influence over, but does not control, this
 entity. On March&amp;#xA0;31, 2017, the Company sold its 75% economic
 interest in a second joint venture. The Company had a management
 agreement with the joint venture and, based on the terms of the
 agreement, the Company had determined that the joint venture was a
 variable interest entity for which the Company was the primary
 beneficiary. Accordingly, through the date of the sale, the
 financial results of the joint venture were fully consolidated into
 the Company&amp;#x2019;s operating results and the equity interests of
 the outside investor in the equity and results of operations of
 this consolidated entity were accounted for and presented as
 noncontrolling interests. See Note 6 for more information regarding
 the deconsolidation of this joint venture.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:ConsolidationPolicyTextBlock>
  <us-gaap:CashAndCashEquivalentsPolicyTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_F54FF919-7734-4F57-AF4C-8EE75AF9016E_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Cash and Cash
 Equivalents&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Cash
 equivalents are defined as all highly liquid financial instruments
 with maturities of 90 days or less from the date of purchase. The
 Company&amp;#x2019;s cash equivalents typically consist of demand
 deposits, amounts on deposit in money market accounts, and funds
 invested in overnight repurchase agreements. Cash equivalent
 balances may, at certain times, exceed federally insured
 limits.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Certain cash
 equivalents carried by the Company are subject to the fair value
 provisions of the accounting guidance for fair value measurements.
 See &amp;#x201C;Fair Value Measurements&amp;#x201D; below.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:CashAndCashEquivalentsPolicyTextBlock>
  <us-gaap:CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_D95A745C-A191-43C2-89A6-8A37C069D3CB_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Restricted
 Cash&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Restricted cash
 consists of funds in escrow related to a potential future payment
 for contingent consideration for an acquisition completed during
 the year ended December&amp;#xA0;31, 2017. See Note 6 for more
 information regarding the underlying contingent consideration
 arrangement.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy>
  <us-gaap:CommitmentsAndContingenciesDisclosureTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_2934E344-0A0D-4275-BFC1-D618F527B556_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;16.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Commitments and
 Contingencies:&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 expects that audits, inquiries and investigations from government
 authorities and agencies will occur in the ordinary course of
 business. Such audits, inquiries and investigations and their
 ultimate resolutions, individually or in the aggregate, could have
 a material adverse effect on the Company&amp;#x2019;s business,
 financial condition, results of operations, cash flows and the
 trading price of its common stock. The Company has not included an
 accrual for these matters as of December&amp;#xA0;31, 2017 in its
 Consolidated Financial Statements, as the variables affecting any
 potential eventual liability depend on the currently unknown facts
 and circumstances that arise out of, and are specific to, any
 particular future audit, inquiry and investigation and cannot be
 reasonably estimated at this time.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In the ordinary
 course of business, the Company becomes involved in pending and
 threatened legal actions and proceedings, most of which involve
 claims of medical malpractice related to medical services provided
 by the Company&amp;#x2019;s affiliated physicians. The Company&amp;#x2019;s
 contracts with hospitals generally require the Company to indemnify
 them and their affiliates for losses resulting from the negligence
 of the Company&amp;#x2019;s affiliated physicians. The Company may also
 become subject to other lawsuits which could involve large claims
 and significant costs. The Company believes, based upon a review of
 pending actions and proceedings, that the outcome of such legal
 actions and proceedings will not have a material adverse effect on
 its business, financial condition, results of operations, cash
 flows and the trading price of its securities. The outcome of such
 actions and proceedings, however, cannot be predicted with
 certainty and an unfavorable resolution of one or more of them
 could have a material adverse effect on the Company&amp;#x2019;s
 business, financial condition, results of operations, cash flows
 and the trading price of its securities.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Although the
 Company currently maintains liability insurance coverage intended
 to cover professional liability and certain other claims, the
 Company cannot assure that its insurance coverage will be adequate
 to cover liabilities arising out of claims asserted against it in
 the future where the outcomes of such claims are unfavorable. With
 respect to professional liability risk, the Company generally
 self-insures a portion of this risk through its wholly owned
 captive insurance subsidiary. Liabilities in excess of the
 Company&amp;#x2019;s insurance coverage, including coverage for
 professional liability and certain other claims, could have a
 material adverse effect on the Company&amp;#x2019;s business, financial
 condition, results of operations, cash flows and the trading price
 of its securities.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 leases space for its regional, medical and business offices,
 storage space and temporary housing of medical staff. The Company
 also leases an aircraft. Rent expense for the years ended
 December&amp;#xA0;31, 2017, 2016 and 2015 was $42.6&amp;#xA0;million,
 $38.0&amp;#xA0;million and $31.6&amp;#xA0;million, respectively.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Future minimum
 lease payments under &lt;font style="WHITE-SPACE: nowrap"&gt;non-cancelable&lt;/font&gt; operating leases as of
 December&amp;#xA0;31, 2017 are as follows (in
 thousands):&lt;b&gt;&amp;#xA0;&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="68%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="83%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2018&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;34,337&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2019&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;24,178&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2020&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;16,633&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2021&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;12,065&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2022&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;8,125&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Thereafter&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;9,934&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;105,272&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:CommitmentsAndContingenciesDisclosureTextBlock>
  <us-gaap:CashAndCashEquivalentsPeriodIncreaseDecrease contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_37">24502000</us-gaap:CashAndCashEquivalentsPeriodIncreaseDecrease>
  <us-gaap:CurrentFederalTaxExpenseBenefit contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_0E9BE689-87B3-4DA2-865B-045CEE0A9702_1_0">130053000</us-gaap:CurrentFederalTaxExpenseBenefit>
  <us-gaap:CurrentStateAndLocalTaxExpenseBenefit contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_0E9BE689-87B3-4DA2-865B-045CEE0A9702_1_3">20070000</us-gaap:CurrentStateAndLocalTaxExpenseBenefit>
  <us-gaap:DebtAndCapitalLeasesDisclosuresTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_6D51A66A-A5F8-4C51-9ED6-CE40B008C2F7_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;10.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Line of Credit, Long-Term Debt
 and Capital Lease Obligations:&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;On
 October&amp;#xA0;30, 2017, the Company entered into a new credit
 agreement (the &amp;#x201C;New Credit Agreement&amp;#x201D;), which replaces
 the Company&amp;#x2019;s prior credit agreement. The New Credit
 Agreement provides for a $2.0&amp;#xA0;billion unsecured revolving
 credit facility and includes a $37.5&amp;#xA0;million &lt;font style="WHITE-SPACE: nowrap"&gt;sub-facility&lt;/font&gt; for the issuance of
 letters of credit. The New Credit Agreement matures on
 October&amp;#xA0;31, 2022 and is guaranteed by substantially all of the
 Company&amp;#x2019;s subsidiaries and affiliated professional
 associations and corporations. At the Company&amp;#x2019;s option,
 borrowings under the New Credit Agreement will bear interest at
 (i)&amp;#xA0;the alternate base rate (defined as the higher of
 (a)&amp;#xA0;the prime rate, (b)&amp;#xA0;the Federal Funds Rate plus 1/2
 of 1.00% and (c)&amp;#xA0;LIBOR for an interest period of one month
 plus 1.00%) plus an applicable margin rate ranging from 0.125% to
 0.750% based on the Company&amp;#x2019;s consolidated leverage ratio or
 (ii)&amp;#xA0;the LIBOR rate plus an applicable margin rate ranging
 from 1.125% to 1.750% based on the Company&amp;#x2019;s consolidated
 leverage ratio. The New Credit Agreement also calls for other
 customary fees and charges, including an unused commitment fee
 ranging from 0.150% to 0.300% of the unused lending commitments,
 based on the Company&amp;#x2019;s consolidated leverage
 ratio.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The New Credit
 Agreement contains customary covenants and restrictions, including
 covenants that require the Company to maintain a minimum interest
 charge ratio, not to exceed a specified consolidated leverage ratio
 and to comply with laws, and restrictions on the ability of the
 Company to pay dividends and make certain other distributions, as
 specified therein. Failure to comply with these covenants would
 constitute an event of default under the New Credit Agreement,
 notwithstanding the ability of the Company to meet its debt service
 obligations. The New Credit Agreement also includes various
 customary remedies for the lenders following an event of default,
 including the acceleration of repayment of outstanding amounts
 under the New Credit Agreement.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;On
 December&amp;#xA0;8, 2015, the Company completed a private offering of
 $750.0&amp;#xA0;million aggregate principal amount of 2023 Senior
 Notes. The Company&amp;#x2019;s obligations under the 2023 Senior Notes
 are guaranteed on an unsecured senior basis by the same
 subsidiaries and affiliated professional contractors that guarantee
 the Credit Agreement. Interest on the 2023 Senior Notes accrues at
 the rate of 5.25% per annum and is payable semi-annually in arrears
 on June&amp;#xA0;1 and December 1.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;At any time
 prior to December&amp;#xA0;1, 2018, the Company may redeem all or a
 portion of the 2023 Senior Notes at a redemption price equal to
 100% of the principal amount of the notes being redeemed plus an
 applicable redemption premium and accrued and unpaid interest to
 the redemption date. In addition, at any time prior to
 December&amp;#xA0;1, 2018, the Company may redeem up to 35% of the
 aggregate principal amount of the 2023 Senior Notes at a redemption
 price of 105.250% of the principal amount thereof, plus accrued and
 unpaid interest, if any, to the redemption date, using proceeds
 from one or more equity offerings. On or after December&amp;#xA0;1,
 2018, the Company may redeem all or a portion of the 2023 Senior
 Notes, at the redemption prices of 103.938% in 2018, 102.625% in
 2019, 101.313% in 2020 and 100% in 2021 and thereafter, plus
 accrued and unpaid interest to the redemption date.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The indenture
 under which the 2023 Senior Notes are issued, among other things,
 limits our ability to (1)&amp;#xA0;incur liens and (2)&amp;#xA0;enter into
 sale and lease-back transactions, and also limits our ability to
 merge or dispose of all or substantially all of our assets, in all
 cases, subject to a number of customary exceptions. Although we are
 not required to make mandatory redemption or sinking fund payments
 with respect to the 2023 Senior Notes, upon the occurrence of a
 change in control of MEDNAX, we may be required to repurchase the
 2023 Senior Notes at a purchase price equal to 101% of the
 aggregate principal amount of the 2023 Senior Notes repurchased
 plus accrued and unpaid interest.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 presents issuance costs related to long-term debt liabilities,
 other than revolving credit arrangements, as a direct deduction
 from the carrying value of that long-term debt.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The carrying
 value of the Company&amp;#x2019;s long-term debt was $1.8&amp;#xA0;billion
 and $1.7&amp;#xA0;billion at December&amp;#xA0;31, 2017 and 2016,
 respectively, and consisted of the following (in
 thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="56%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,
 2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Principal&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Unamortized&lt;br /&gt;
 Debt&lt;br /&gt;
 Issuance&lt;br /&gt;
 Costs&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Total&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2023 Senior
 Notes&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;750,000&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(9,503&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;740,497&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Revolving line of
 credit&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,110,500&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(4,864&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,105,636&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Total&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,860,500&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(14,367&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,846,133&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="57%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,
 2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Principal&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Unamortized&lt;br /&gt;
 Debt&lt;br /&gt;
 Issuance&lt;br /&gt;
 Costs&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Total&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2023 Senior
 Notes&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;750,000&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(11,109&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;738,891&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Revolving line of
 credit&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;783,500&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(3,388&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;780,112&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Term loan&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;180,000&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(259&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;179,741&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,713,500&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(14,756&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,698,744&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Less: Current
 portion&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(20,000&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(20,000&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Long-term
 portion&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,693,500&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(14,756&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,678,744&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company has
 outstanding letters of credit which reduced the amount available
 under the New Credit Agreement by $0.2&amp;#xA0;million at
 December&amp;#xA0;31, 2017. At December&amp;#xA0;31, 2017, the Company had
 an available balance on its New Credit Agreement of
 $889.3&amp;#xA0;million.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The carrying
 values of the Company&amp;#x2019;s variable rate revolving line of
 credit approximates fair value due to the short-term nature of the
 interest rates. The estimated fair value of the Company&amp;#x2019;s
 2023 Notes was $763.1&amp;#xA0;million and $773.4&amp;#xA0;million, at
 December&amp;#xA0;31, 2017 and 2016, respectively, and was estimated
 using trading prices as of December&amp;#xA0;31, 2017 and
 December&amp;#xA0;31, 2016 as Level&amp;#xA0;2 inputs to estimate fair
 value.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The
 Company&amp;#x2019;s capital lease obligations consist of the following
 (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="75%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="6" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Capital lease
 obligations&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,826&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;3,550&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Less: Current
 portion&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(1,401&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(2,054&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Long-term
 portion&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;425&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,496&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The amounts due
 under the terms of the Company&amp;#x2019;s capital lease obligations at
 December&amp;#xA0;31, 2017 are as follows:&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="68%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="86%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2018&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,401&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2019&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;238&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2020&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;113&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2021&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;74&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:DebtAndCapitalLeasesDisclosuresTextBlock>
  <dei:CurrentFiscalYearEndDate contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_6B6A89F4-5FCF-4B5C-912E-DF8AAA83141B_1_3">--12-31</dei:CurrentFiscalYearEndDate>
  <us-gaap:DefinedContributionPlanCostRecognized contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_E1F18978-8B82-4270-818D-2F184E54CB48_1_0">50700000</us-gaap:DefinedContributionPlanCostRecognized>
  <us-gaap:DeferredFederalIncomeTaxExpenseBenefit contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_0E9BE689-87B3-4DA2-865B-045CEE0A9702_1_1">-63038000</us-gaap:DeferredFederalIncomeTaxExpenseBenefit>
  <us-gaap:DeferredIncomeTaxExpenseBenefit contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_6">-60073000</us-gaap:DeferredIncomeTaxExpenseBenefit>
  <us-gaap:DeferredStateAndLocalIncomeTaxExpenseBenefit contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_0E9BE689-87B3-4DA2-865B-045CEE0A9702_1_4">2965000</us-gaap:DeferredStateAndLocalIncomeTaxExpenseBenefit>
  <us-gaap:Depreciation contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_4CA522F8-7387-4756-AE59-26BA276B2CFF_1_2">33900000</us-gaap:Depreciation>
  <us-gaap:DepreciationDepletionAndAmortization contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_5">102879000</us-gaap:DepreciationDepletionAndAmortization>
  <us-gaap:EarningsPerShareTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_7A03F5BB-F7DD-46E6-90FD-DA4EB8D06BEB_1_0">&lt;div&gt;
 &lt;p style="margin-top:18px;margin-bottom:0px"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&lt;b&gt;12.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Common and Common Equivalent
 Shares:&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="margin-top:6px;margin-bottom:0px; text-indent:4%"&gt;
 &lt;font style="font-family:Times New Roman" size="2"&gt;The calculation
 of shares used in the basic and diluted net income per share
 calculation for the years ended December&amp;#xA0;31, 2017, 2016 and
 2015 is as follows (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="font-size:12px;margin-top:0px;margin-bottom:0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table cellspacing="0" cellpadding="0" width="92%" border="0" style="BORDER-COLLAPSE:COLLAPSE" align="center"&gt;
 &lt;tr&gt;
 &lt;td width="73%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="10" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Weighted average number of
 common shares outstanding&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;92,431&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;92,422&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;93,077&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Weighted average number of
 dilutive common share equivalents&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;527&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;687&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;883&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Weighted average number of
 common and common equivalent shares outstanding&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;92,958&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;93,109&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;93,960&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Antidilutive securities not
 included in the diluted net income per common share
 calculation&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;107&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;2&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:EarningsPerShareTextBlock>
  <us-gaap:EffectiveIncomeTaxRateContinuingOperations contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="pure" decimals="4" id="id_12960622_12F6ADC7-EFAD-4C29-A4B6-F8D0060BC7A6_1_0">0.2194</us-gaap:EffectiveIncomeTaxRateContinuingOperations>
  <us-gaap:DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_0C9DAFC2-3EFA-42FA-8BB3-12D08A8BF395_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;13.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Stock Incentive Plans and Stock
 Purchase Plans:&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The
 Company&amp;#x2019;s Amended and Restated 2008 Incentive Compensation
 Plan, as amended (the &amp;#x201C;Amended and Restated 2008 Incentive
 Plan&amp;#x201D;) provides for grants of stock options, stock
 appreciation rights, restricted stock, deferred stock, and other
 stock-related awards and performance awards that may be settled in
 cash, stock or other property.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Under the
 Amended and Restated 2008 Incentive Plan, options to purchase
 shares of common stock may be granted at a price not less than the
 fair market value of the shares on the date of grant. The options
 must be exercised within 10 years from the date of grant and
 generally become exercisable on a pro rata basis over a three-year
 period from the date of grant. The Company issues new shares of its
 common stock upon exercise of its stock options. Restricted stock
 awards generally vest over periods of three years upon the
 fulfillment of specified service-based conditions and in certain
 instances performance-based conditions. Deferred stock awards
 generally vest upon the satisfaction of specified performance-based
 conditions or service-based conditions. The Company recognizes
 compensation expense related to its restricted stock and deferred
 stock awards ratably over the corresponding vesting periods. At
 December&amp;#xA0;31, 2017, the Company had 3.4&amp;#xA0;million shares
 available for future grants and awards under its Amended and
 Restated 2008 Incentive Plan.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Under the
 Company&amp;#x2019;s 1996 &lt;font style="WHITE-SPACE: nowrap"&gt;Non-Qualified&lt;/font&gt; Employee Stock Purchase
 Plan, as amended (the &amp;#x201C;ESPP&amp;#x201D;), employees are permitted
 to purchase the Company&amp;#x2019;s common stock at 85% of market value
 on January 1st, April 1st, July 1st and October 1st of each year.
 Under the Company&amp;#x2019;s 2015 &lt;font style="WHITE-SPACE: nowrap"&gt;Non-Qualified&lt;/font&gt; Stock Purchase Plan (the
 &amp;#x201C;SPP&amp;#x201D;), certain eligible non-employee service providers
 are permitted to purchase the Company&amp;#x2019;s common stock at 90%
 of market value on January 1st, April 1st, July 1st and October 1st
 of each year upon the SPP&amp;#x2019;s effective date of January&amp;#xA0;1,
 2016.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Each of the
 ESPP and the SPP provide for the issuance of an of aggregate
 2.6&amp;#xA0;million shares of the Company&amp;#x2019;s common stock less
 the number of shares of common stock purchased under the other
 plan. The Company recognizes stock-based compensation expense for
 the discount received by participating employees and &lt;font style="WHITE-SPACE: nowrap"&gt;non-employee&lt;/font&gt; service providers. During
 the year ended December&amp;#xA0;31, 2017, 0.4&amp;#xA0;million shares were
 issued under the ESPP and SPP. At December&amp;#xA0;31, 2017, the
 Company had 1.9&amp;#xA0;million shares in aggregate reserved for
 issuance under the ESPP and SPP.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 recognized $29.6&amp;#xA0;million, $34.0&amp;#xA0;million and
 $32.1&amp;#xA0;million of stock-based compensation expense related to
 its stock incentive plans, the ESPP and the SPP during the years
 ended December&amp;#xA0;31, 2017, 2016 and 2015,
 respectively.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The activity
 related to the Company&amp;#x2019;s restricted stock and deferred stock
 awards and the corresponding weighted average grant-date fair
 values for the year ended December&amp;#xA0;31, 2017 are as
 follows:&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="68%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Number
 of&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Shares&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Weighted&lt;br /&gt;
 Average&amp;#xA0;Fair&lt;br /&gt;
 Value&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;Non-vested&lt;/font&gt; shares at January&amp;#xA0;1,
 2017&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;946,329&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;66.98&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Awarded&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;637,529&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;54.22&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Forfeited&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(91,730&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;64.82&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Vested&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(451,094&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;65.00&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;Non-vested&lt;/font&gt; shares at December&amp;#xA0;31,
 2017&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,041,034&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;60.21&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The aggregate
 fair value of the restricted and deferred stock that vested during
 the years ended December&amp;#xA0;31, 2017, 2016 and 2015 was
 $29.3&amp;#xA0;million, $29.8&amp;#xA0;million and $31.6&amp;#xA0;million,
 respectively.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The weighted
 average grant-date fair value of restricted and deferred stock
 awards that were granted during the years ended December&amp;#xA0;31,
 2017, 2016 and 2015 was $54.22, $67.90 and $70.44,
 respectively.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;At
 December&amp;#xA0;31, 2017, the total stock-based compensation cost
 related to &lt;font style="WHITE-SPACE: nowrap"&gt;non-vested&lt;/font&gt;
 restricted and deferred stock remaining to be recognized as
 compensation expense over a weighted-average period of 1.6 years
 was $30.9&amp;#xA0;million.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company did
 not grant any stock options in 2017, 2016 or 2015, and all
 stock-based compensation cost related to stock options has been
 recognized. The activity and certain other information related to
 the Company&amp;#x2019;s outstanding stock option awards for the year
 ended December&amp;#xA0;31, 2017 are as follows:&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="51%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Number&amp;#xA0;of&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Stock&amp;#xA0;
 Options&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Weighted&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Average&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Exercise&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Price&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Weighted&lt;br /&gt;
 Average&lt;br /&gt;
 Remaining&lt;br /&gt;
 Contractual&lt;br /&gt;
 Term&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;(in
 years)&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Aggregate&lt;br /&gt;
 Intrinsic&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Value&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;(in&amp;#xA0;millions)&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Outstanding at
 January&amp;#xA0;1, 2017&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;410,286&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;28.33&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Exercised&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(163,944&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;29.57&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;5.5&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Outstanding and exercisable
 at December&amp;#xA0;31, 2017&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;246,342&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;27.51&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1.5&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;6.4&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The aggregate
 intrinsic value of stock options exercised during the years ended
 December&amp;#xA0;31, 2017, 2016 and 2015 was $5.5&amp;#xA0;million,
 $6.8&amp;#xA0;million and $11.3&amp;#xA0;million, respectively.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;There were no
 excess tax benefits recognized in additional &lt;font style="WHITE-SPACE: nowrap"&gt;paid-in&lt;/font&gt; capital due to the adoption of
 new accounting guidance on January&amp;#xA0;1, 2017 that requires
 excess tax benefits to be recognized in the income statement. The
 net excess tax benefit recognized in additional &lt;font style="WHITE-SPACE: nowrap"&gt;paid-in&lt;/font&gt; capital related primarily to
 stock options, restricted stock and deferred stock for the years
 ended December&amp;#xA0;31, 2016 and 2015 was $4.1&amp;#xA0;million and
 $11.6&amp;#xA0;million, respectively. The cash proceeds received from
 the exercise of stock options for the years ended December&amp;#xA0;31,
 2017, 2016 and 2015 were $4.8&amp;#xA0;million, $4.7&amp;#xA0;million and
 $6.1&amp;#xA0;million, respectively.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock>
  <dei:DocumentFiscalPeriodFocus contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_0AA7986C-2BB9-40B6-8A69-28C8034B5E4C_1_4">FY</dei:DocumentFiscalPeriodFocus>
  <dei:DocumentFiscalYearFocus contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_0AA7986C-2BB9-40B6-8A69-28C8034B5E4C_1_3">2017</dei:DocumentFiscalYearFocus>
  <dei:DocumentType contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_0AA7986C-2BB9-40B6-8A69-28C8034B5E4C_1_0">10-K</dei:DocumentType>
  <us-gaap:EarningsPerShareDiluted contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_19">3.45</us-gaap:EarningsPerShareDiluted>
  <us-gaap:EarningsPerSharePolicyTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_B030F88D-73BE-41C8-8D71-5CAD2B104DF5_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Net Income Per Common
 Share&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Basic net
 income per common share is calculated by dividing net income by the
 weighted average number of common shares outstanding during the
 period. Diluted net income per common share is calculated by
 dividing net income by the weighted average number of common and
 potential common shares outstanding during the period. Potential
 common shares consist of outstanding restricted stock, deferred
 stock and stock options and is calculated using the treasury stock
 method. On January&amp;#xA0;1, 2017, the Company adopted new accounting
 guidance that no longer permits the Company to include the assumed
 excess tax benefits related to the potential exercise or vesting of
 its stock-based awards in the treasury stock method computation.
 The impact on the weighted average number of common and common
 equivalent shares outstanding from excluding such assumed excess
 tax benefits for the year ended December&amp;#xA0;31, 2017 was not
 material. See &amp;#x201C;Recently Adopted Accounting
 Pronouncements&amp;#x201D; above for additional information on the
 adoption of the new accounting guidance.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:EarningsPerSharePolicyTextBlock>
  <us-gaap:EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="pure" decimals="INF" id="id_12960622_F8ABEAE9-0EA6-4A4F-94C5-4FD0BD7F0BBE_1_0">0.3500</us-gaap:EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate>
  <us-gaap:EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="pure" decimals="4" id="id_12960622_F8ABEAE9-0EA6-4A4F-94C5-4FD0BD7F0BBE_1_5">0.0016</us-gaap:EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent>
  <dei:DocumentPeriodEndDate contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_0AA7986C-2BB9-40B6-8A69-28C8034B5E4C_1_2">2017-12-31</dei:DocumentPeriodEndDate>
  <us-gaap:EarningsPerShareBasic contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_18">3.47</us-gaap:EarningsPerShareBasic>
  <us-gaap:EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="pure" decimals="4" id="id_12960622_F8ABEAE9-0EA6-4A4F-94C5-4FD0BD7F0BBE_1_1">0.0333</us-gaap:EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes>
  <dei:EntityRegistrantName contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_6B6A89F4-5FCF-4B5C-912E-DF8AAA83141B_1_1">MEDNAX, INC.</dei:EntityRegistrantName>
  <dei:EntityVoluntaryFilers contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_6B6A89F4-5FCF-4B5C-912E-DF8AAA83141B_1_6">No</dei:EntityVoluntaryFilers>
  <dei:EntityCentralIndexKey contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_6B6A89F4-5FCF-4B5C-912E-DF8AAA83141B_1_2">0000893949</dei:EntityCentralIndexKey>
  <dei:EntityWellKnownSeasonedIssuer contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_6B6A89F4-5FCF-4B5C-912E-DF8AAA83141B_1_4">Yes</dei:EntityWellKnownSeasonedIssuer>
  <us-gaap:FairValueOfFinancialInstrumentsPolicy contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_6D1E3DED-FEEE-4EDB-973E-0D35C17A82E3_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Fair Value
 Measurements&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In accordance
 with the accounting guidance for fair value measurements and
 disclosures, the Company carries its money market funds included in
 cash and cash equivalents at fair value. In accordance with the
 three-tier fair value hierarchy under this guidance, the Company
 determined the fair value using quoted market prices, a
 Level&amp;#xA0;1 input as defined under the accounting guidance for
 fair value measurements. At December&amp;#xA0;31, 2017 and 2016, the
 Company&amp;#x2019;s money market funds had a fair value of
 $9.2&amp;#xA0;million and $12.4&amp;#xA0;million, respectively.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 also carries the cash surrender value of life insurance related to
 its deferred compensation arrangements at fair value. The
 investments underlying the life insurance contracts consist
 primarily of exchange-traded equity securities and mutual funds
 with quoted prices in active markets. In accordance with the
 three-tier fair value hierarchy, the Company determined the fair
 value using the cash surrender value of the life insurance, a
 Level&amp;#xA0;2 input as defined under the accounting guidance for
 fair value measurements. At December&amp;#xA0;31, 2017 and 2016, the
 Company&amp;#x2019;s cash surrender value of life insurance had a fair
 value of $15.6&amp;#xA0;million and $15.8&amp;#xA0;million,
 respectively.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In addition,
 the Company carries its contingent consideration liabilities
 related to acquisitions at fair value. In accordance with the
 three-tier fair value hierarchy, the Company determined the fair
 value of its contingent consideration liabilities using the income
 approach with assumed discount rates and payment probabilities. The
 income approach uses Level&amp;#xA0;3, or unobservable inputs as
 defined under the accounting guidance for fair value measurements.
 At December&amp;#xA0;31, 2017 and 2016, the Company&amp;#x2019;s contingent
 consideration liabilities had a fair value of $30.5&amp;#xA0;million
 and $17.3&amp;#xA0;million, respectively. See Note 6 for more
 information regarding the Company&amp;#x2019;s contingent consideration
 liabilities.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The carrying
 amounts of cash equivalents, short-term investments, accounts
 receivable and accounts payable and accrued expenses approximate
 fair value due to the short maturities of the respective
 instruments. The carrying values of long-term investments, line of
 credit, variable rate long-term debt and capital lease obligations
 approximate fair value. If the Company&amp;#x2019;s investments were
 measured at fair value, they would be categorized as Level&amp;#xA0;2
 in the fair value hierarchy. If the Company&amp;#x2019;s line of credit
 and variable long-term debt were measured at fair value, they would
 be categorized as Level&amp;#xA0;2 in the fair value hierarchy. See
 Note 10 for information regarding the fair value of the
 Company&amp;#x2019;s 5.25% senior unsecured notes due 2023 (the
 &amp;#x201C;2023 Notes&amp;#x201D;).&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:FairValueOfFinancialInstrumentsPolicy>
  <us-gaap:EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="pure" decimals="4" id="id_12960622_F8ABEAE9-0EA6-4A4F-94C5-4FD0BD7F0BBE_1_6">-0.1706</us-gaap:EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate>
  <us-gaap:EffectiveIncomeTaxRateReconciliationNondeductibleExpense contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="pure" decimals="4" id="id_12960622_F8ABEAE9-0EA6-4A4F-94C5-4FD0BD7F0BBE_1_2">0.0049</us-gaap:EffectiveIncomeTaxRateReconciliationNondeductibleExpense>
  <us-gaap:EffectiveIncomeTaxRateReconciliationOtherAdjustments contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="pure" decimals="4" id="id_12960622_F8ABEAE9-0EA6-4A4F-94C5-4FD0BD7F0BBE_1_3">0.0002</us-gaap:EffectiveIncomeTaxRateReconciliationOtherAdjustments>
  <dei:EntityCurrentReportingStatus contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_6B6A89F4-5FCF-4B5C-912E-DF8AAA83141B_1_5">Yes</dei:EntityCurrentReportingStatus>
  <dei:EntityFilerCategory contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_6B6A89F4-5FCF-4B5C-912E-DF8AAA83141B_1_7">Large Accelerated Filer</dei:EntityFilerCategory>
  <us-gaap:FederalIncomeTaxExpenseBenefitContinuingOperations contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_0E9BE689-87B3-4DA2-865B-045CEE0A9702_1_2">67015000</us-gaap:FederalIncomeTaxExpenseBenefitContinuingOperations>
  <us-gaap:GoodwillAndIntangibleAssetsDisclosureTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_43570DF0-4DF5-412C-BB98-795F0FBA42A0_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;7.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Goodwill and Intangible
 Assets:&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Goodwill was
 $4.3&amp;#xA0;billion and $3.8&amp;#xA0;billion at December&amp;#xA0;31, 2017
 and 2016, respectively. The change in the carrying amount of
 goodwill of $438.8&amp;#xA0;million during the year ended
 December&amp;#xA0;31, 2017 is primarily related to the Company&amp;#x2019;s
 2017 acquisitions. The Company expects that $159.5&amp;#xA0;million of
 the goodwill recorded during the year ended December&amp;#xA0;31, 2017
 will be deductible for tax purposes.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Intangible
 assets, net, consist of the following (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="64%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,
 2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Gross&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Accumulated&lt;br /&gt;
 Amortization&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Net&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Physician and hospital
 agreements&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;381,635&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(203,915&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;177,720&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Customer
 relationships&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;443,300&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(48,837&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;394,463&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Trade names&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;43,156&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(2,933&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;40,223&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Patented and other
 technology&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;38,590&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(11,068&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;27,522&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;906,681&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(266,753&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;639,928&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="64%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,
 2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Gross&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Accumulated&lt;br /&gt;
 Amortization&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Net&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Physician and hospital
 agreements&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;347,862&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(168,488&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;179,374&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Customer
 relationships&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;443,300&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(27,368&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;415,932&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Trade names&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;43,156&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(1,604&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;41,552&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Patented and other
 technology&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;37,503&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(5,832&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;31,671&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;871,821&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(203,292&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;668,529&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;During the year
 ended December&amp;#xA0;31, 2017, the Company recorded intangible
 assets related to acquisitions totaling $39.4&amp;#xA0;million,
 consisting primarily of physician and hospital agreements. The
 weighted-average amortization period for these physician and
 hospital agreements is approximately 10 years.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Amortization
 expense for intangible assets was $68.9&amp;#xA0;million,
 $60.3&amp;#xA0;million and $42.0&amp;#xA0;million for the years ended
 December&amp;#xA0;31, 2017, 2016 and 2015, respectively.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Amortization
 expense for existing intangible assets for the next five years is
 expected to be as follows (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="68%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="84%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2018&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;67,514&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2019&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;62,669&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2020&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;56,636&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2021&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;51,069&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2022&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;44,357&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:GoodwillAndIntangibleAssetsDisclosureTextBlock>
  <us-gaap:GoodwillPeriodIncreaseDecrease contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_C852D67D-1A96-4C6C-8BAA-E091E7C5FC5F_1_1">438800000</us-gaap:GoodwillPeriodIncreaseDecrease>
  <us-gaap:GoodwillAndIntangibleAssetsPolicyTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_E5E5E3F4-42EE-4D72-83AB-0B02DCE59303_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Goodwill and Other
 Intangible Assets&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 records acquired assets and assumed liabilities at their respective
 fair values under the acquisition method of accounting. Goodwill
 represents the excess of purchase price over the fair value of the
 net assets acquired. Intangible assets with finite lives,
 principally physician and hospital agreements, customer
 relationships, patented technology and trade names, are recognized
 apart from goodwill at the time of acquisition based on the
 contractual-legal and separability criteria established in the
 accounting guidance. Intangible assets with finite lives are
 amortized on either an accelerated basis based on the annual
 undiscounted economic cash flows associated with the particular
 intangible asset or on a straight-line basis over their estimated
 useful lives. Intangible assets with finite lives are amortized
 over periods of one to 20 years.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Goodwill is
 tested for impairment at a reporting unit level on at least an
 annual basis in accordance with the subsequent measurement
 provisions of the accounting guidance for goodwill. The Company
 defines a reporting unit based upon its management structure for
 services provided in specific regions of the United States. The
 Company early adopted new accounting guidance in 2017 that requires
 only a single-step quantitative test with any goodwill impairment
 measured as the amount by which a reporting unit&amp;#x2019;s carrying
 value exceeds its fair value. The Company uses income and
 market-based valuation approaches to determine the fair value of
 its reporting units. These approaches focus on discounted cash
 flows and market multiples based on the Company&amp;#x2019;s market
 capitalization to derive the fair value of a reporting unit. The
 Company also considers the economic outlook for the healthcare
 services industry and various other factors during the testing
 process, including hospital and physician contract changes, local
 market developments, changes in third-party payor payments, and
 other publicly available information. The Company completed annual
 impairment tests in the third quarter of each of 2017, 2016 and
 2015 and determined that goodwill was not impaired in any of the
 three years.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:GoodwillAndIntangibleAssetsPolicyTextBlock>
  <us-gaap:HealthCareOrganizationRevenue contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_0">3458312000</us-gaap:HealthCareOrganizationRevenue>
  <us-gaap:HeldToMaturitySecuritiesTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_2A1817F1-11C3-4382-93DC-F862EA7AD5F0_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 Investments held are summarized as follows (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="52%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31, 2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31, 2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;Short-Term&lt;/font&gt;&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;Long-Term&lt;/font&gt;&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;Short-Term&lt;/font&gt;&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;Long-Term&lt;/font&gt;&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Municipal debt securities&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;8,312&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;46,195&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;10,306&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;46,513&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Federal home loan securities&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,000&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;30,322&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;28,747&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Certificates of deposit&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;980&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;4,165&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;980&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;3,715&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;10,292&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;80,682&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;11,286&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;78,975&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:HeldToMaturitySecuritiesTextBlock>
  <us-gaap:FinitelivedIntangibleAssetsAcquired1 contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_45258714-D0DE-41AE-8319-4FA0B418CCB8_1_0">39400000</us-gaap:FinitelivedIntangibleAssetsAcquired1>
  <us-gaap:FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_11D6018A-A9A4-4897-A92F-3442859D5DED_1_0">&lt;div&gt;
 &lt;p style="margin-top:12px;margin-bottom:0px; text-indent:4%"&gt;
 &lt;font style="font-family:Times New Roman" size="2"&gt;Amortization
 expense for existing intangible assets for the next five years is
 expected to be as follows (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="font-size:12px;margin-top:0px;margin-bottom:0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table cellspacing="0" cellpadding="0" width="68%" border="0" style="BORDER-COLLAPSE:COLLAPSE" align="center"&gt;
 &lt;tr&gt;
 &lt;td width="84%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;2018&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;67,514&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;2019&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;62,669&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;2020&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;56,636&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;2021&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;51,069&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;2022&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;44,357&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock>
  <us-gaap:GeneralAndAdministrativeExpense contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_4">417105000</us-gaap:GeneralAndAdministrativeExpense>
  <us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_12">410422000</us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest>
  <us-gaap:IncomeTaxDisclosureTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_A3CE9787-2322-4DB9-92D3-69A3110D830B_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 0pt"&gt;
 &lt;b&gt;11.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Income Taxes:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 The components of the income tax provision (benefit) are as follows
 (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="62%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Federal:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Current&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;130,053&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;166,758&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;168,596&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Deferred&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(63,038&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;15,596&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;12,866&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;67,015&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;182,354&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;181,462&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 State:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Current&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;20,070&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;4,296&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;20,948&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Deferred&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,965&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,553&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,628&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;23,035&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;6,849&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;22,576&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;90,050&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;189,203&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;204,038&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 The Company files its tax return on a consolidated basis with its
 subsidiaries. The remaining affiliated professional contractors
 file tax returns on an individual basis.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 The effective tax rate was 21.94%, 36.80% and 37.76% for the years
 ended December&amp;#xA0;31, 2017, 2016 and 2015, respectively. During
 the three months ended December&amp;#xA0;31, 2017, the Company recorded
 a $70.0&amp;#xA0;million income tax benefit related to the reduction of
 its net deferred tax liability resulting from the reduction in the
 corporate tax rate enacted in December 2017 under the Tax Cuts and
 Jobs Act of 2017. Excluding this favorable impact, our effective
 income tax rate for the year ended December&amp;#xA0;31, 2017 was
 39.00%. During the three months ended September&amp;#xA0;30, 2016, the
 Company settled a certain tax matter with a taxing authority. In
 connection with this settlement, the Company&amp;#x2019;s effective
 income tax rate was favorably impacted by $10.6&amp;#xA0;million.
 Excluding this favorable impact, the effective tax rate for
 December&amp;#xA0;31, 2016 was 38.87%, as compared to 37.76% for
 2015.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 The differences between the effective rate and the United States
 federal income tax statutory rate are as follows:&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="75%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Tax at statutory rate&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;35.00&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;35.00&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;35.00&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 State income tax, net of federal benefit&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;3.33&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2.94&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2.97&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 &lt;font style="WHITE-SPACE: nowrap"&gt;Non-deductible&lt;/font&gt;
 expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.49&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.43&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.34&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Change in accrual estimates relating to uncertain tax positions&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.02&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(2.11&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(0.43&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Change in valuation allowance&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.48&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.29&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Other, net&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.16&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.06&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(0.41&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Change in tax law&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17.06&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income tax provision&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;21.94&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;36.80&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;37.76&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;All of the
 Company&amp;#x2019;s deferred tax assets and liabilities are classified
 as long-term. The significant components of deferred income tax
 assets and liabilities are as follows (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="69%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="6" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Allowance for uncollectible
 accounts&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;80,056&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;103,525&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Reserves and
 accruals&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;45,454&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;62,212&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Stock-based
 compensation&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;7,975&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;13,726&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Net operating loss
 carryforward&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;28,569&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;49,156&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Property and
 equipment&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;685&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,621&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Other&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;970&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,610&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Deferred tax assets before
 valuation allowance&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;163,709&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;231,850&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Less: Valuation
 allowance&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(2,615&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(4,014&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Deferred tax assets, net of
 valuation allowance&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;161,094&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;227,836&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Gross deferred tax
 liabilities:&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Amortization&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(258,618&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(380,594&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Accrual to cash
 adjustment&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(31,290&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(53,771&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Other&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(4,150&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(1,023&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 5em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Total deferred tax
 liabilities&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(294,058&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(435,388&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 5em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Net deferred tax
 liability&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(132,964&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(207,552&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The
 Company&amp;#x2019;s net deferred tax liability decreased by
 $74.6&amp;#xA0;million during 2017 of which $70.0&amp;#xA0;million is
 related to a reduction in the corporate tax rate enacted under the
 Tax Cuts and Jobs Act of 2017.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Beginning
 January&amp;#xA0;1, 2017, excess tax benefits or deficiencies
 associated with the exercise of stock options, the vesting of
 restricted and deferred stock and the purchase of shares under the
 Company&amp;#x2019;s &lt;font style="WHITE-SPACE: nowrap"&gt;non-qualified&lt;/font&gt; employee stock purchase
 plan are recognized as income tax benefits or expenses in the
 income statement in the reporting period in which they occur
 instead of an increase or decrease to additional &lt;font style="WHITE-SPACE: nowrap"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;paid-in-capital.&lt;/font&gt;&lt;/font&gt; For the year
 ended December&amp;#xA0;31, 2017, income tax expense of
 $0.2&amp;#xA0;million was recognized for excess tax deficiencies. For
 the years ended December&amp;#xA0;31, 2016 and 2015, respectively,
 additional &lt;font style="WHITE-SPACE: nowrap"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;paid-in-capital&lt;/font&gt;&lt;/font&gt; was increased
 by $4.2&amp;#xA0;million and $11.6&amp;#xA0;million for excess tax
 benefits.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company has
 net operating loss carryforwards for federal and state tax purposes
 totaling $116.0&amp;#xA0;million, $130.0&amp;#xA0;million, and
 $136.6&amp;#xA0;million at December&amp;#xA0;31, 2017, 2016 and 2015,
 respectively, expiring at various times in 2019 through
 2037.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;As of
 December&amp;#xA0;31, 2017, 2016 and 2015, the Company&amp;#x2019;s
 liability for uncertain tax positions, excluding accrued interest
 and penalties, was $11.0&amp;#xA0;million, $9.5&amp;#xA0;million and
 $18.4&amp;#xA0;million, respectively. As of December&amp;#xA0;31, 2017, the
 Company had $10.7&amp;#xA0;million of uncertain tax positions that, if
 recognized, would favorably impact its effective tax
 rate.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The following
 table summarizes the activity related to the Company&amp;#x2019;s
 liability for uncertain tax positions for the years ended
 December&amp;#xA0;31, 2017, 2016 and 2015 (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="66%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Balance at beginning of
 year&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;9,469&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;18,447&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;17,165&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Increases related to prior
 year tax positions&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2,284&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;301&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;467&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Decreases related to prior
 year tax positions&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(143&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(3,927&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(1,168&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Increases related to
 current year tax positions&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,430&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2,258&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;3,675&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Settlements&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(5,644&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Decreases related to lapse
 of statutes of limitation&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(2,068&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(1,966&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(1,692&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Balance at end of
 year&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;10,972&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;9,469&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;18,447&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;During the year
 ended December&amp;#xA0;31, 2017, the Company increased its liability
 for uncertain tax positions by a total of $1.5&amp;#xA0;million,
 primarily related to additional taxes on current and prior year
 positions, partially offset by the expiration of statutes of
 limitation. During the year ended December&amp;#xA0;31, 2016, the
 Company decreased its liability for uncertain tax positions by a
 total of $9.0&amp;#xA0;million, primarily related to the settlement of
 a certain tax matter with a taxing authority and the expiration of
 statutes of limitation, partially offset by additional taxes on
 current year positions.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In addition,
 the Company anticipates that its liability for uncertain tax
 positions will be decreased by $1.1&amp;#xA0;million related to the
 expiration of certain statutes of limitation over the next 12
 months.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 includes interest and penalties related to income tax liabilities
 in income tax expense. The Company recognized an income tax benefit
 of $0.2&amp;#xA0;million and $7.9&amp;#xA0;million and income tax expense
 of $0.6&amp;#xA0;million related to interest and penalties during the
 years ended December&amp;#xA0;31, 2017, 2016 and 2015, respectively. At
 December&amp;#xA0;31, 2017 and 2016, the Company&amp;#x2019;s accrued
 liability for interest and penalties related to income tax
 liabilities totaled $1.2&amp;#xA0;million and $1.4&amp;#xA0;million,
 respectively.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company is
 currently subject to U.S. Federal and various state income tax
 examinations for the tax years 2013 through 2016.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:IncomeTaxDisclosureTextBlock>
  <us-gaap:IncomeTaxesPaidNet contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_43">75427000</us-gaap:IncomeTaxesPaidNet>
  <us-gaap:ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_EC69F253-BEBD-4CA4-931C-4808255209DF_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Long-Lived
 Assets&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company is
 required to evaluate long-lived assets, including intangible assets
 subject to amortization, whenever events or changes in
 circumstances indicate that the carrying value of the assets may
 not be fully recoverable. The recoverability of such assets is
 measured by a comparison of the carrying value of the assets to the
 future undiscounted cash flows before interest charges to be
 generated by the assets. If long-lived assets are impaired, the
 impairment to be recognized is measured as the excess of the
 carrying value over the fair value. Long-lived assets held for
 disposal are reported at the lower of the carrying value or fair
 value less disposal costs. The Company does not believe there are
 any indicators that would require an adjustment to such assets or
 their estimated periods of recovery at December&amp;#xA0;31, 2017
 pursuant to current accounting standards.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock>
  <us-gaap:IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_7F2B4881-ABF7-455B-8325-2A8092193811_1_1">-70000000</us-gaap:IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability>
  <us-gaap:IncomeTaxPolicyTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_A5CB9A73-880B-4546-8FE2-72F712145B43_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Income
 Taxes&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 records deferred income taxes using the liability method, whereby
 deferred tax assets and liabilities are determined based on the
 difference between the financial statement and tax bases of assets
 and liabilities using enacted tax rates in effect for the year in
 which the differences are expected to reverse. If it is more likely
 than not that all or a portion of deferred tax assets will not be
 realized, a valuation allowance is provided against such deferred
 tax assets. In making such determination, the Company considers all
 available positive and negative evidence, including future
 reversals of existing taxable temporary differences, projected
 future taxable income, &lt;font style="WHITE-SPACE: nowrap"&gt;tax-planning&lt;/font&gt; strategies, and results
 of recent operations.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The accounting
 guidance for uncertain tax positions prescribes a recognition
 threshold and measurement attribute for financial statement
 recognition and measurement of a tax position taken or expected to
 be taken in a tax return. The guidance also requires policy
 disclosures regarding penalties and interest and extensive
 disclosures regarding increases and decreases in uncertain tax
 positions as a result of tax positions taken in a current or prior
 period, settlements with taxing authorities and any lapse of an
 applicable statute of limitations. Additional qualitative
 discussion is required for any tax position that may result in a
 significant increase or decrease in uncertain tax positions within
 a &lt;font style="WHITE-SPACE: nowrap"&gt;12-month&lt;/font&gt; period from the
 Company&amp;#x2019;s reporting date.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:IncomeTaxPolicyTextBlock>
  <us-gaap:IncreaseDecreaseInAccountsPayableAndAccruedLiabilities contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_12">24551000</us-gaap:IncreaseDecreaseInAccountsPayableAndAccruedLiabilities>
  <us-gaap:IncreaseDecreaseInAccruedIncomeTaxesPayable contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_13">73050000</us-gaap:IncreaseDecreaseInAccruedIncomeTaxesPayable>
  <us-gaap:IncreaseDecreaseInOtherNoncurrentAssets contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_11">2709000</us-gaap:IncreaseDecreaseInOtherNoncurrentAssets>
  <us-gaap:IncreaseDecreaseInAccountsReceivable contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_9">-7803000</us-gaap:IncreaseDecreaseInAccountsReceivable>
  <us-gaap:IncreaseDecreaseInOtherOperatingLiabilities contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_16">-735000</us-gaap:IncreaseDecreaseInOtherOperatingLiabilities>
  <us-gaap:IncrementalCommonSharesAttributableToShareBasedPaymentArrangements contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="shares" decimals="-3" id="id_12960622_B39A4D88-4B0F-4B52-9D25-83B0A6E7727C_1_1">527000</us-gaap:IncrementalCommonSharesAttributableToShareBasedPaymentArrangements>
  <us-gaap:IncomeLossFromEquityMethodInvestments contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_10">952000</us-gaap:IncomeLossFromEquityMethodInvestments>
  <us-gaap:IncomeTaxExpenseBenefit contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_13">90050000</us-gaap:IncomeTaxExpenseBenefit>
  <us-gaap:IncreaseDecreaseInDeferredLiabilities contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_7F2B4881-ABF7-455B-8325-2A8092193811_1_0">-74600000</us-gaap:IncreaseDecreaseInDeferredLiabilities>
  <us-gaap:IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_10">2792000</us-gaap:IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets>
  <us-gaap:InterestExpense contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_9">74559000</us-gaap:InterestExpense>
  <us-gaap:InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_C101F4E3-E546-402B-B5CC-4ADB96CFEBF1_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 0pt"&gt;
 &lt;b&gt;3.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Investments:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 Investments held are summarized as follows (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="52%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31, 2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31, 2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;Short-Term&lt;/font&gt;&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;Long-Term&lt;/font&gt;&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;Short-Term&lt;/font&gt;&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;Long-Term&lt;/font&gt;&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Municipal debt securities&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;8,312&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;46,195&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;10,306&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;46,513&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Federal home loan securities&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,000&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;30,322&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;28,747&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Certificates of deposit&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;980&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;4,165&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;980&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;3,715&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;10,292&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;80,682&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;11,286&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;78,975&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 Contractual maturities of long-term investments are summarized as
 follows (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="74%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Due after one year through five years&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;78,561&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;70,005&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Due after five years through six years&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,121&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;8,970&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;80,682&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;78,975&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock>
  <us-gaap:InvestmentIncomeNet contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_8">3953000</us-gaap:InvestmentIncomeNet>
  <us-gaap:InterestPaidNet contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_42">73837000</us-gaap:InterestPaidNet>
  <us-gaap:InvestmentsClassifiedByContractualMaturityDateTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_CFE68721-7E3D-4D80-B023-C1B2A5712827_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 Contractual maturities of long-term investments are summarized as
 follows (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="74%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Due after one year through five years&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;78,561&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;70,005&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Due after five years through six years&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,121&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;8,970&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;80,682&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;78,975&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:InvestmentsClassifiedByContractualMaturityDateTableTextBlock>
  <us-gaap:InvestmentPolicyTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_257F6832-8D87-4C68-81AB-670A64279569_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Investments&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Investments
 consist of municipal debt securities, federal home loan securities
 and certificates of deposit. Investments with remaining maturities
 of less than one year are classified as short-term investments.
 Investments classified as long-term have maturities of one year to
 six years.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 intends and has the ability to hold its securities to maturity, and
 therefore carries such investments at amortized cost in accordance
 with the provisions of the accounting guidance for investments in
 debt securities.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:InvestmentPolicyTextBlock>
  <us-gaap:LeaseAndRentalExpense contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_EE9712D3-97B1-4A81-8E2B-8BF49C99CA3A_1_0">42600000</us-gaap:LeaseAndRentalExpense>
  <us-gaap:LineOfCreditFacilityExpirationDate1 contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_34A7B8C5-D581-44C3-88F6-FFFEC636DBB4_1_2">2022-10-31</us-gaap:LineOfCreditFacilityExpirationDate1>
  <us-gaap:LoansNotesTradeAndOtherReceivablesDisclosureTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_0E6F2CA0-6889-45A1-BAF0-0B43543CC00A_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt"&gt;
 &lt;b&gt;4.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Accounts Receivable and Net
 Revenue:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 Accounts receivable, net consists of the following (in
 thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="65%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Gross accounts receivable&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,790,034&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,719,642&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Allowance for contractual adjustments and uncollectibles&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(1,286,035&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(1,224,366&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;503,999&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;495,276&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 Net revenue consists of the following (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="59%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Gross revenue&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;11,427,238&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;10,374,813&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;8,942,957&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Contractual adjustments and uncollectibles&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(8,285,317&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(7,464,030&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(6,389,195&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Hospital contract administrative fees&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;316,391&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;272,376&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;226,234&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;3,458,312&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;3,183,159&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,779,996&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 Accounts receivable of $504.0&amp;#xA0;million and $495.3&amp;#xA0;million
 at December&amp;#xA0;31, 2017 and 2016, respectively, consist primarily
 of amounts due from government-sponsored healthcare programs and
 third-party insurance payors for services provided by the
 Company&amp;#x2019;s affiliated physicians.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 Net revenue of $3.5&amp;#xA0;billion, $3.2&amp;#xA0;billion and
 $2.8&amp;#xA0;billion for the years ended December&amp;#xA0;31, 2017, 2016
 and 2015, respectively, consists primarily of gross billed charges
 for services provided by the Company&amp;#x2019;s affiliated physicians
 less an estimated allowance for contractual adjustments and
 uncollectibles to properly account for the anticipated differences
 between gross billed charge amounts and expected reimbursement
 amounts.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 The Company&amp;#x2019;s contractual adjustments and uncollectibles as a
 percentage of gross patient service revenue vary slightly each year
 depending on several factors, including improved managed care
 contracting, changes in reimbursement from state Medicaid programs
 and other government-sponsored programs, shifts in the percentage
 of patient services being reimbursed under government-sponsored
 programs and annual price increases.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The
 Company&amp;#x2019;s annual price increases typically increase
 contractual adjustments as a percentage of gross patient service
 revenue. This increase is primarily due to Medicaid, Medicare and
 other government-sponsored healthcare programs that generally
 provide for reimbursements on a &lt;font style="WHITE-SPACE: nowrap"&gt;fee-schedule&lt;/font&gt; basis rather than on a
 gross charge basis. When the Company bills these programs, like
 other payors, on a gross-charge basis, it also increases its
 provision for contractual adjustments and uncollectibles by the
 amount of any price increase, resulting in a higher contractual
 adjustment percentage.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:LoansNotesTradeAndOtherReceivablesDisclosureTextBlock>
  <us-gaap:MalpracticeLossContingencyClaimsIncurredInPeriod contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_6DED415F-A549-49CA-8D83-9DC6D6B4D6B9_1_5">712000</us-gaap:MalpracticeLossContingencyClaimsIncurredInPeriod>
  <us-gaap:MalpracticeLossContingencyClaimsIncurredInPriorPeriods contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_6DED415F-A549-49CA-8D83-9DC6D6B4D6B9_1_6">23143000</us-gaap:MalpracticeLossContingencyClaimsIncurredInPriorPeriods>
  <us-gaap:MalpracticeLossContingencyClaimsIncurredNet contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_6DED415F-A549-49CA-8D83-9DC6D6B4D6B9_1_7">23855000</us-gaap:MalpracticeLossContingencyClaimsIncurredNet>
  <us-gaap:MalpracticeLossContingencyDisclosureTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_CD2AD416-6EA5-4FBA-8D34-AFD5F4393F63_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;9.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Accrued Professional
 Liabilities:&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;At
 December&amp;#xA0;31, 2017 and 2016, the Company&amp;#x2019;s total accrued
 professional liabilities of $250.2&amp;#xA0;million and
 $202.1&amp;#xA0;million, respectively, includes incurred but not
 reported loss reserves of $138.5&amp;#xA0;million and
 $128.1&amp;#xA0;million, respectively, and loss reserves for reported
 claims of $111.7&amp;#xA0;million and $74.0&amp;#xA0;million, respectively.
 Of the total liability, $37.9&amp;#xA0;million is classified as a
 current liability within accounts payable and accrued expenses in
 the Consolidated Balance Sheet. In addition, there is a
 corresponding insurance receivable of $18.9&amp;#xA0;million recorded
 as a component of other assets for certain professional liability
 claims that are covered by third-party insurance
 policies.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The activity
 related to the Company&amp;#x2019;s total accrued professional liability
 for the years ended December&amp;#xA0;31, 2017, 2016 and 2015 is as
 follows (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="63%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Balance at beginning of
 year&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;202,052&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;202,527&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;168,369&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Assumed liabilities through
 acquisition&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;20,716&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;35,968&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Provision (adjustment) for
 losses related to:&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Current year&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;41,291&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;38,129&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;39,204&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Prior years&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;9,983&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(25,428&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(25,797&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Total provision for
 losses&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;51,274&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;12,701&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;13,407&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Claim payments related
 to:&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Current year&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(712&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(766&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(1,382&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Prior years&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(23,143&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(12,410&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(13,835&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Total payments&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(23,855&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(13,176&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(15,217&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Balance at end of
 year&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;250,187&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;202,052&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;202,527&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The net
 increase in the Company&amp;#x2019;s total accrued professional
 liability for the year ended December&amp;#xA0;31, 2017 is primarily
 related to growth in the program from acquisitions as well as
 overall unfavorable trends in the Company&amp;#x2019;s claims
 experience. The net decrease in 2016 was primarily attributable to
 the overall favorable trends in the Company&amp;#x2019;s claims
 experience.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:MalpracticeLossContingencyDisclosureTextBlock>
  <us-gaap:MalpracticeLossContingencyPeriodIncreaseDecrease contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_15">18478000</us-gaap:MalpracticeLossContingencyPeriodIncreaseDecrease>
  <us-gaap:NatureOfOperations contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_A0417597-83A7-4875-84E4-6DB61BA0CBC5_1_0">&lt;div&gt;
 &lt;p style="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"&gt;
 &lt;b&gt;1.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;General:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 The principal business activity of MEDNAX, Inc.
 (&amp;#x201C;MEDNAX&amp;#x201D; or the &amp;#x201C;Company&amp;#x201D;) and its
 subsidiaries is to provide neonatal, anesthesia, radiology and
 teleradiology, maternal-fetal and other pediatric subspecialty
 physician services. The Company has contracts with affiliated
 business corporations or professional associations, limited
 liability companies and partnerships (&amp;#x201C;affiliated
 professional contractors&amp;#x201D;), which are separate legal entities
 that provide physician services in certain states and Puerto Rico.
 The Company and its affiliated professional contractors also have
 contracts with hospitals and other healthcare facilities to provide
 physician services, which include &lt;font style="white-space:nowrap"&gt;&lt;font style="white-space:nowrap"&gt;(i)&amp;#xA0;fee-for-service&lt;/font&gt;&lt;/font&gt;
 contracts, whereby hospitals and other customers agree, in exchange
 for the Company&amp;#x2019;s services, to authorize the Company and its
 healthcare professionals to bill and collect the charges for
 medical services rendered by the Company&amp;#x2019;s affiliated
 healthcare professionals, and (ii)&amp;#xA0;administrative fee
 contracts, whereby the Company is assured a minimum revenue
 level.&lt;/p&gt;
 &lt;p style="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 In addition to its national physician network, the Company also
 provides services nationwide to healthcare providers, including its
 own, through complementary businesses including a management
 services organization specializing in full-service revenue cycle
 management and a consulting services company.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:NatureOfOperations>
  <us-gaap:NetCashProvidedByUsedInInvestingActivitiesContinuingOperations contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_24">-576613000</us-gaap:NetCashProvidedByUsedInInvestingActivitiesContinuingOperations>
  <us-gaap:NetCashProvidedByUsedInOperatingActivitiesContinuingOperations contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_17">511378000</us-gaap:NetCashProvidedByUsedInOperatingActivitiesContinuingOperations>
  <us-gaap:OperatingExpenses contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_6">2978236000</us-gaap:OperatingExpenses>
  <us-gaap:NetCashProvidedByUsedInFinancingActivitiesContinuingOperations contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_36">89737000</us-gaap:NetCashProvidedByUsedInFinancingActivitiesContinuingOperations>
  <us-gaap:NetIncomeLoss contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_16">320372000</us-gaap:NetIncomeLoss>
  <us-gaap:OperatingIncomeLoss contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_7">480076000</us-gaap:OperatingIncomeLoss>
  <us-gaap:NewAccountingPronouncementsPolicyPolicyTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_7EDA5C00-064C-4C94-85A4-FEBA000EA839_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;New Accounting
 Pronouncements&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In February
 2016, the accounting guidance related to leases was issued that
 will require an entity to recognize leased assets and the rights
 and obligations created by those leased assets on the balance sheet
 and to disclose key information about the entity&amp;#x2019;s leasing
 arrangements. This guidance will become effective for the Company
 on January&amp;#xA0;1, 2019, with early adoption permitted. The Company
 expects that the adoption of this guidance will have a material
 impact on its Consolidated Balance Sheets and related disclosures,
 resulting from the recognition of significant right of use assets
 and related liabilities primarily related to its operating lease
 arrangements for space in hospitals and certain other facilities
 for its business and medical offices. The Company is in the process
 of reviewing its existing lease portfolio and accumulating all of
 the necessary information required to properly account for leases
 under the new guidance.&amp;#xA0;Additionally, the Company is assessing
 system requirements, required changes to its processes and internal
 control implications to ensure the Company will meet the reporting
 and disclosure requirements. The Company&amp;#x2019;s evaluation of this
 guidance and its impacts are expected to continue through the third
 quarter of 2018.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In May 2014,
 the accounting guidance related to revenue recognition was amended
 to outline a single, comprehensive model for accounting for revenue
 from contracts with customers. The core principle of the new
 accounting guidance is to require an entity to recognize as revenue
 the amount that reflects the consideration to which it expects to
 be entitled in exchange for goods or services as it transfers
 control to its customers.&amp;#xA0;The new guidance will become
 effective for the Company on January&amp;#xA0;1, 2018. The
 Company&amp;#x2019;s current revenue recognition policies for its
 significant revenue streams materially comply with the amended
 guidance. The primary change for healthcare providers under the new
 guidance is the requirement to report the allowance for
 uncollectibles associated with patient responsibility amounts as a
 reduction in net revenue as opposed to bad debt expense as a
 component of operating expenses. The Company has historically
 included the allowance for uncollectibles associated with patient
 responsibility amounts with its allowance for contractual
 adjustments as a reduction in net revenue as such amounts are not
 material. Accordingly, the adoption of this guidance will not have
 an impact on our Consolidated Financial Statements.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:NewAccountingPronouncementsPolicyPolicyTextBlock>
  <us-gaap:NonoperatingIncomeExpense contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_11">-69654000</us-gaap:NonoperatingIncomeExpense>
  <us-gaap:OtherNoncashIncomeExpense contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_7">3783000</us-gaap:OtherNoncashIncomeExpense>
  <us-gaap:PaymentsForPreviousAcquisition contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_E4D952F7-AB00-43D4-8D6B-485F0AB44B2B_1_0">6200000</us-gaap:PaymentsForPreviousAcquisition>
  <us-gaap:PaymentsOfFinancingCosts contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_29">3525000</us-gaap:PaymentsOfFinancingCosts>
  <us-gaap:PaymentsToAcquireInvestments contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_20">27723000</us-gaap:PaymentsToAcquireInvestments>
  <us-gaap:PaymentsToAcquireOtherPropertyPlantAndEquipment contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_22">49309000</us-gaap:PaymentsToAcquireOtherPropertyPlantAndEquipment>
  <us-gaap:PaymentsForRepurchaseOfCommonStock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_35">70192000</us-gaap:PaymentsForRepurchaseOfCommonStock>
  <us-gaap:PaymentsToAcquireBusinessesNetOfCashAcquired contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_19">531696000</us-gaap:PaymentsToAcquireBusinessesNetOfCashAcquired>
  <us-gaap:PaymentForContingentConsiderationLiabilityFinancingActivities contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_30">5449000</us-gaap:PaymentForContingentConsiderationLiabilityFinancingActivities>
  <us-gaap:PaymentForContingentConsiderationLiabilityOperatingActivities contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_14">750000</us-gaap:PaymentForContingentConsiderationLiabilityOperatingActivities>
  <us-gaap:PaymentsForProceedsFromOtherInvestingActivities contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_23">-6705000</us-gaap:PaymentsForProceedsFromOtherInvestingActivities>
  <us-gaap:PaymentsToAcquireBusinessesGross contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_C795A629-E311-4179-965D-2E2D3C59C2DD_1_7">531700000</us-gaap:PaymentsToAcquireBusinessesGross>
  <us-gaap:PensionAndOtherPostretirementBenefitsDisclosureTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_1694F262-E4BB-4EA2-A111-2FD3C8DBD1B2_1_0">&lt;div&gt;
 &lt;p style="margin-top:18px;margin-bottom:0px"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&lt;b&gt;15.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Retirement Plans:&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="margin-top:6px;margin-bottom:0px; text-indent:4%"&gt;
 &lt;font style="font-family:Times New Roman" size="2"&gt;The Company
 maintains six qualified contributory savings plans as allowed under
 Section&amp;#xA0;401(k) of the Internal Revenue Code and
 Section&amp;#xA0;1165(e) of the Puerto Rico Income Tax Act of 1954 (the
 &amp;#x201C;401(k) Plans&amp;#x201D;). The 401(k) Plans permit participant
 contributions and allow elective and, in certain situations,
 &lt;font style="white-space:nowrap"&gt;non-elective&lt;/font&gt; Company
 contributions based on each participant&amp;#x2019;s contribution or a
 specified percentage of eligible wages. Participants may defer a
 percentage of their annual compensation subject to the limits
 defined in the 401(k) Plans. The Company recorded expense of
 $50.7&amp;#xA0;million, $45.2&amp;#xA0;million and $39.7&amp;#xA0;million for
 the years ended December&amp;#xA0;31, 2017, 2016 and 2015,
 respectively, primarily related to the 401(k) Plans.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:PensionAndOtherPostretirementBenefitsDisclosureTextBlock>
  <us-gaap:ProceedsFromIssuanceOfCommonStock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_33">23276000</us-gaap:ProceedsFromIssuanceOfCommonStock>
  <us-gaap:ProceedsFromMinorityShareholders contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_34">894000</us-gaap:ProceedsFromMinorityShareholders>
  <us-gaap:ProceedsFromSaleMaturityAndCollectionsOfInvestments contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_21">25410000</us-gaap:ProceedsFromSaleMaturityAndCollectionsOfInvestments>
  <us-gaap:ProfitLoss contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_14">320372000</us-gaap:ProfitLoss>
  <us-gaap:PropertyPlantAndEquipmentTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_AC5E02B1-8AEF-4D14-B5C9-659765D94047_1_0">&lt;div&gt;
 &lt;p style="margin-top:6px;margin-bottom:0px; text-indent:4%"&gt;
 &lt;font style="font-family:Times New Roman" size="2"&gt;Property and
 equipment consists of the following (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="font-size:12px;margin-top:0px;margin-bottom:0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table cellspacing="0" cellpadding="0" width="76%" border="0" style="BORDER-COLLAPSE:COLLAPSE" align="center"&gt;
 &lt;tr&gt;
 &lt;td width="69%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="6" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Building&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;33,024&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;26,572&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Land&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;6,683&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;6,683&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Equipment and
 other&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;253,453&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;213,521&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;293,160&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;246,776&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Accumulated
 depreciation&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;(169,624&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;(143,708&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;123,536&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;103,068&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:PropertyPlantAndEquipmentTextBlock>
  <us-gaap:ProceedsAndExcessTaxBenefitFromSharebasedCompensation contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_826F5FF2-24AC-47A7-8172-69D6989CB4C0_1_1">4800000</us-gaap:ProceedsAndExcessTaxBenefitFromSharebasedCompensation>
  <us-gaap:PropertyPlantAndEquipmentPolicyTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_B6B55B95-AFFC-4F8D-9DD1-E8D8D8741246_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Property and
 Equipment&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Property and
 equipment are recorded at original purchase cost. Depreciation of
 property and equipment is computed using the straight-line method
 over the estimated useful lives of the underlying assets. Estimated
 useful lives are generally 30 years for buildings; three to seven
 years for medical equipment, computer equipment, software and
 furniture; and the lesser of the useful life or the remaining lease
 term for leasehold improvements and capital leases. Upon sale or
 retirement of property and equipment, the related cost and
 accumulated depreciation are eliminated from the respective
 accounts and any resulting gain or loss is included in
 earnings.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:PropertyPlantAndEquipmentPolicyTextBlock>
  <us-gaap:ProceedsFromLinesOfCredit contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_26">2846000000</us-gaap:ProceedsFromLinesOfCredit>
  <us-gaap:PropertyPlantAndEquipmentDisclosureTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_987A4582-FFEF-41A5-80A6-476608C2C098_1_0">&lt;div&gt;
 &lt;p style="margin-top:18px;margin-bottom:0px"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&lt;b&gt;5.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Property and
 Equipment:&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="margin-top:6px;margin-bottom:0px; text-indent:4%"&gt;
 &lt;font style="font-family:Times New Roman" size="2"&gt;Property and
 equipment consists of the following (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="font-size:12px;margin-top:0px;margin-bottom:0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table cellspacing="0" cellpadding="0" width="76%" border="0" style="BORDER-COLLAPSE:COLLAPSE" align="center"&gt;
 &lt;tr&gt;
 &lt;td width="69%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="6" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Building&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;33,024&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;26,572&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Land&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;6,683&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;6,683&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Equipment and
 other&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;253,453&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;213,521&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;293,160&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;246,776&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Accumulated
 depreciation&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;(169,624&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;(143,708&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;123,536&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;103,068&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="margin-top:12px;margin-bottom:0px; text-indent:4%"&gt;
 &lt;font style="font-family:Times New Roman" size="2"&gt;At
 December&amp;#xA0;31, 2017 and 2016, property and equipment includes
 medical and other equipment held under capital leases of
 $6.1&amp;#xA0;million and $6.2&amp;#xA0;million, and related accumulated
 depreciation of $4.6&amp;#xA0;million and $4.0&amp;#xA0;million,
 respectively. The Company recorded depreciation expense of
 $33.9&amp;#xA0;million, $29.0&amp;#xA0;million and $22.2&amp;#xA0;million for
 the years ended December&amp;#xA0;31, 2017, 2016 and 2015,
 respectively.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:PropertyPlantAndEquipmentDisclosureTextBlock>
  <us-gaap:RepaymentsOfLinesOfCredit contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_27">2699000000</us-gaap:RepaymentsOfLinesOfCredit>
  <us-gaap:QuarterlyFinancialInformationTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_02104607-06DF-420F-85BE-14F21E8C4086_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 0pt"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;17.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Selected Quarterly Financial
 Information (Unaudited):&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The following
 tables set forth a summary of the Company&amp;#x2019;s selected
 quarterly financial information for each of the four quarters ended
 December&amp;#xA0;31, 2017 and 2016 (in thousands, except for per share
 data):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="100%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="64%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="14" align="center"&gt;&lt;b&gt;2017 Quarters&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;First&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Second&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Third&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Fourth&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net revenue&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;835,597&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;842,944&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;868,951&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;910,820&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Operating expenses:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice salaries and benefits&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;572,385&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;561,418&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;586,476&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;617,455&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice supplies and other operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27,796&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;30,872&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;29,497&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;32,353&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 General and administrative expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;103,765&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;103,015&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;101,430&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;108,895&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Depreciation and amortization&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;25,614&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;25,735&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;25,116&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;26,414&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;729,560&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;721,040&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;742,519&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;785,117&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income from operations&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;106,037&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;121,904&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;126,432&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;125,703&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Investment and other income&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;576&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;365&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;235&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,777&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Interest expense&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17,752&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(18,535&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(18,428&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(19,844&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Equity (losses) in earnings of unconsolidated affiliate&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;797&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;689&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(240&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(294&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total &lt;font style="WHITE-SPACE: nowrap"&gt;non-operating&lt;/font&gt;
 expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(16,379&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17,481&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(18,433&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17,361&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income before income taxes&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;89,658&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;104,423&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;107,999&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;108,342&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income tax (provision) benefit&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(34,967&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(40,725&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(42,119&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27,761&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income attributable to MEDNAX, Inc.&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;54,691&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;63,698&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;65,880&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;136,103&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Per common and common equivalent share data (1):&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income attributable to MEDNAX, Inc.:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.59&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.69&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.71&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1.47&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.59&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.69&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.71&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1.46&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Weighted average common shares:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,360&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,181&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,589&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,756&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,143&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,812&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,881&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,159&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="100%" border="0"&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top" width="4%" align="left"&gt;(1)&lt;/td&gt;
 &lt;td valign="top" align="left"&gt;Basic and diluted per share amounts
 are computed for each of the periods presented. Accordingly, the
 sum of the quarterly per share amounts may not agree with the full
 year amount.&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="100%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="64%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="14" align="center"&gt;&lt;b&gt;2016 Quarters&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;First&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Second&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Third&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Fourth&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net revenue&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;752,624&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;771,759&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;828,006&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;830,770&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Operating expenses:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice salaries and benefits&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;491,811&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;484,625&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;521,832&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;532,952&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice supplies and other operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27,046&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;26,992&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;31,641&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;32,737&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 General and administrative expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;89,950&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,116&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,457&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;97,049&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Depreciation and amortization&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;19,584&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;20,241&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;24,185&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;25,254&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;628,391&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;623,974&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;671,115&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;687,992&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income from operations&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;124,233&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;147,785&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;156,891&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;142,778&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Investment and other income&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;618&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;410&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;221&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;770&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Interest expense&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(14,463&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(15,058&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17,215&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(16,356&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Equity in earnings of unconsolidated affiliate&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;794&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;789&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;796&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;806&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total &lt;font style="WHITE-SPACE: nowrap"&gt;non-operating&lt;/font&gt;
 expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(13,051&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(13,859&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(16,198&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(14,780&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income before income taxes&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;111,182&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;133,926&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;140,693&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;127,998&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income tax provision&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(43,411&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(51,601&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(44,272&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(49,919&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;67,771&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;82,325&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;96,421&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;78,079&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net loss attributable to noncontrolling interests&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;128&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;102&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;88&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income attributable to MEDNAX, Inc.&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;67,899&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;82,427&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;96,509&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;78,079&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Per common and common equivalent share data (2):&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income attributable to MEDNAX, Inc.:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.74&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.89&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1.04&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.84&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.73&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.89&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1.04&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.84&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Weighted average common shares:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,269&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,182&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,604&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,728&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,091&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,945&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,146&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,347&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="100%" border="0"&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top" width="4%" align="left"&gt;(2)&lt;/td&gt;
 &lt;td valign="top" align="left"&gt;Basic and diluted per share amounts
 are computed for each of the periods presented. Accordingly, the
 sum of the quarterly per share amounts may not agree with the full
 year amount.&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:QuarterlyFinancialInformationTextBlock>
  <us-gaap:RepaymentsOfLongTermCapitalLeaseObligations contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_A7A3AD4A-4736-4E52-9463-75E4A82C5DBC_1_31">2267000</us-gaap:RepaymentsOfLongTermCapitalLeaseObligations>
  <us-gaap:ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_09C921BD-28E1-4D3D-B9F7-497F62BA5A6F_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 The components of the income tax provision (benefit) are as follows
 (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="62%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Federal:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Current&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;130,053&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;166,758&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;168,596&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Deferred&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(63,038&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;15,596&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;12,866&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;67,015&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;182,354&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;181,462&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 State:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Current&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;20,070&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;4,296&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;20,948&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Deferred&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,965&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,553&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,628&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;23,035&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;6,849&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;22,576&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;90,050&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;189,203&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;204,038&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock>
  <us-gaap:RevenueRecognitionPolicyTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_F651125F-6E30-4FB6-94B5-BCBA489DE029_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Revenue
 Recognition&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Patient service
 revenue is recognized at the time services are provided by the
 Company&amp;#x2019;s affiliated physicians. Almost all of the
 Company&amp;#x2019;s patient service revenue is reimbursed by
 government-sponsored healthcare programs and third-party insurance
 payors. Payments for services rendered to the Company&amp;#x2019;s
 patients are generally less than billed charges. The Company
 monitors its revenue and receivables from these sources and records
 an estimated contractual allowance to properly account for the
 anticipated differences between billed and reimbursed
 amounts.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Accordingly,
 patient service revenue is presented net of an estimated provision
 for contractual adjustments and uncollectibles. The Company
 estimates allowances for contractual adjustments and uncollectibles
 on accounts receivable based upon historical experience and other
 factors, including days sales outstanding (&amp;#x201C;DSO&amp;#x201D;) for
 accounts receivable, evaluation of expected adjustments and
 delinquency rates, past adjustments and collection experience in
 relation to amounts billed, an aging of accounts receivable,
 current contract and reimbursement terms, changes in payor mix and
 other relevant information. Contractual adjustments result from the
 difference between the physician rates for services performed and
 the reimbursements by government-sponsored healthcare programs and
 insurance companies for such services.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In addition,
 the Company generates revenue for services rendered under various
 coding and billing contracts. Contract terms are specific to each
 customer and may include a combination of a flat fee for coding of
 medical charts, a fixed fee per patient visit as well as a
 percentage of cash collections received by the providers. Revenue
 for flat and fixed fee arrangements is recognized in the month the
 coding occurs or the patient visit occurs. Revenue for percentage
 fees are recognized in the month that cash is collected for
 customers from payors. Revenue recorded for these services during
 2017 were immaterial.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Accounts
 receivable are primarily amounts due under &lt;font style="WHITE-SPACE: nowrap"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;fee-for-service&lt;/font&gt;&lt;/font&gt; contracts from
 third-party payors, such as insurance companies, self-insured
 employers and patients and government-sponsored healthcare programs
 geographically dispersed throughout the United States and its
 territories. Concentration of credit risk relating to accounts
 receivable is limited by the number, diversity and geographic
 dispersion of the business units managed by the Company, as well as
 by the large number of patients and payors, including the various
 governmental agencies in the states in which the Company provides
 services. Receivables from government agencies made up
 approximately 17% of net accounts receivable at December&amp;#xA0;31,
 2017 and 2016.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:RevenueRecognitionPolicyTextBlock>
  <us-gaap:ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_BD01F625-3E20-4368-B4E9-22222131EF27_1_0">&lt;div&gt;
 &lt;p style="margin-top:6px;margin-bottom:0px; text-indent:4%"&gt;
 &lt;font style="font-family:Times New Roman" size="2"&gt;Accounts payable
 and accrued expenses consist of the following (in
 thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="font-size:12px;margin-top:0px;margin-bottom:0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table cellspacing="0" cellpadding="0" width="76%" border="0" style="BORDER-COLLAPSE:COLLAPSE" align="center"&gt;
 &lt;tr&gt;
 &lt;td width="70%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="6" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Accounts payable&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;34,632&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;28,474&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Accrued salaries and
 bonuses&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;225,429&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;220,635&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Accrued payroll taxes and
 benefits&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;75,672&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;67,830&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Accrued professional
 liabilities&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;37,912&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;28,972&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Accrued contingent
 consideration&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;6,259&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;6,566&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Accrued interest&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;4,495&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;4,511&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Other accrued
 expenses&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;53,618&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;50,950&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;438,017&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;407,938&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock>
  <us-gaap:ScheduleOfDebtTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_8441F346-9C17-4005-9A62-305BD84C68FF_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The carrying
 value of the Company&amp;#x2019;s long-term debt was $1.8&amp;#xA0;billion
 and $1.7&amp;#xA0;billion at December&amp;#xA0;31, 2017 and 2016,
 respectively, and consisted of the following (in
 thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="56%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,
 2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Principal&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Unamortized&lt;br /&gt;
 Debt&lt;br /&gt;
 Issuance&lt;br /&gt;
 Costs&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Total&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2023 Senior
 Notes&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;750,000&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(9,503&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;740,497&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Revolving line of
 credit&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,110,500&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(4,864&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,105,636&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Total&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,860,500&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(14,367&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,846,133&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="57%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,
 2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Principal&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Unamortized&lt;br /&gt;
 Debt&lt;br /&gt;
 Issuance&lt;br /&gt;
 Costs&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Total&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2023 Senior
 Notes&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;750,000&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(11,109&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;738,891&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Revolving line of
 credit&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;783,500&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(3,388&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;780,112&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Term loan&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;180,000&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(259&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;179,741&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,713,500&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(14,756&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,698,744&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Less: Current
 portion&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(20,000&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(20,000&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Long-term
 portion&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,693,500&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(14,756&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,678,744&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfDebtTableTextBlock>
  <us-gaap:ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_A40429E0-8C9A-4DC6-8A00-AA35405A5587_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;All of the
 Company&amp;#x2019;s deferred tax assets and liabilities are classified
 as long-term. The significant components of deferred income tax
 assets and liabilities are as follows (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="69%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="6" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Allowance for uncollectible
 accounts&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;80,056&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;103,525&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Reserves and
 accruals&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;45,454&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;62,212&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Stock-based
 compensation&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;7,975&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;13,726&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Net operating loss
 carryforward&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;28,569&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;49,156&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Property and
 equipment&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;685&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,621&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Other&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;970&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,610&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Deferred tax assets before
 valuation allowance&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;163,709&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;231,850&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Less: Valuation
 allowance&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(2,615&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(4,014&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Deferred tax assets, net of
 valuation allowance&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;161,094&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;227,836&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Gross deferred tax
 liabilities:&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Amortization&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(258,618&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(380,594&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Accrual to cash
 adjustment&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(31,290&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(53,771&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Other&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(4,150&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(1,023&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 5em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Total deferred tax
 liabilities&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(294,058&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(435,388&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 5em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Net deferred tax
 liability&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(132,964&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(207,552&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock>
  <us-gaap:ScheduleOfRevenueSourcesHealthCareOrganizationTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_02B28E38-6A69-46D8-BB2E-948186062953_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 Net revenue consists of the following (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="59%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Gross revenue&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;11,427,238&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;10,374,813&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;8,942,957&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Contractual adjustments and uncollectibles&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(8,285,317&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(7,464,030&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(6,389,195&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Hospital contract administrative fees&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;316,391&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;272,376&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;226,234&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;3,458,312&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;3,183,159&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,779,996&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfRevenueSourcesHealthCareOrganizationTableTextBlock>
  <us-gaap:ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_937DB4ED-B1FE-45CC-9996-8405779AC17B_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The activity
 related to the Company&amp;#x2019;s restricted stock and deferred stock
 awards and the corresponding weighted average grant-date fair
 values for the year ended December&amp;#xA0;31, 2017 are as
 follows:&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="68%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Number
 of&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Shares&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Weighted&lt;br /&gt;
 Average&amp;#xA0;Fair&lt;br /&gt;
 Value&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;Non-vested&lt;/font&gt; shares at January&amp;#xA0;1,
 2017&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;946,329&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;66.98&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Awarded&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;637,529&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;54.22&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Forfeited&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(91,730&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;64.82&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Vested&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(451,094&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;65.00&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;Non-vested&lt;/font&gt; shares at December&amp;#xA0;31,
 2017&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,041,034&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;60.21&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock>
  <us-gaap:ScheduleOfWeightedAverageNumberOfSharesTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_22C52321-C129-4D4C-ABE2-AC19DC9E4AD9_1_0">&lt;div&gt;
 &lt;p style="margin-top:6px;margin-bottom:0px; text-indent:4%"&gt;
 &lt;font style="font-family:Times New Roman" size="2"&gt;The calculation
 of shares used in the basic and diluted net income per share
 calculation for the years ended December&amp;#xA0;31, 2017, 2016 and
 2015 is as follows (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="font-size:12px;margin-top:0px;margin-bottom:0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table cellspacing="0" cellpadding="0" width="92%" border="0" style="BORDER-COLLAPSE:COLLAPSE" align="center"&gt;
 &lt;tr&gt;
 &lt;td width="73%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="10" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"&gt;&lt;font style="font-family:Times New Roman" size="1"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Weighted average number of
 common shares outstanding&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;92,431&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;92,422&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;93,077&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Weighted average number of
 dilutive common share equivalents&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;527&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;687&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;883&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:1px solid #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Weighted average number of
 common and common equivalent shares outstanding&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;92,958&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;93,109&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;93,960&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="margin-left:1.00em; text-indent:-1.00em"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;Antidilutive securities not
 included in the diluted net income per common share
 calculation&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;107&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;2&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom" align="right"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&lt;font style="font-family:Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="font-size:1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="border-top:3px double #000000"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfWeightedAverageNumberOfSharesTableTextBlock>
  <us-gaap:ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_8E0FE24B-3A00-414D-90D1-AA1736DAF024_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 Accounts receivable, net consists of the following (in
 thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="65%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Gross accounts receivable&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,790,034&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,719,642&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Allowance for contractual adjustments and uncollectibles&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(1,286,035&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(1,224,366&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;503,999&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;495,276&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock>
  <us-gaap:ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_2125B288-321C-4F7C-897D-28263C4C0496_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Intangible
 assets, net, consist of the following (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="64%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,
 2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Gross&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Accumulated&lt;br /&gt;
 Amortization&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Net&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Physician and hospital
 agreements&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;381,635&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(203,915&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;177,720&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Customer
 relationships&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;443,300&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(48,837&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;394,463&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Trade names&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;43,156&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(2,933&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;40,223&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Patented and other
 technology&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;38,590&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(11,068&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;27,522&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;906,681&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(266,753&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;639,928&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="64%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,
 2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Gross&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Accumulated&lt;br /&gt;
 Amortization&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Net&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Physician and hospital
 agreements&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;347,862&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(168,488&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;179,374&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Customer
 relationships&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;443,300&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(27,368&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;415,932&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Trade names&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;43,156&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(1,604&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;41,552&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Patented and other
 technology&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;37,503&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(5,832&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;31,671&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;871,821&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(203,292&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;668,529&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock>
  <us-gaap:ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_0414667D-AFBB-4FAE-824A-F9E0F0865AA3_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The amounts due
 under the terms of the Company&amp;#x2019;s capital lease obligations at
 December&amp;#xA0;31, 2017 are as follows:&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="68%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="86%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2018&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,401&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2019&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;238&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2020&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;113&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2021&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;74&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock>
  <us-gaap:ScheduleOfQuarterlyFinancialInformationTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_1D47C3C4-BE10-4B20-B882-8A6458B3FC56_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The following
 tables set forth a summary of the Company&amp;#x2019;s selected
 quarterly financial information for each of the four quarters ended
 December&amp;#xA0;31, 2017 and 2016 (in thousands, except for per share
 data):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="100%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="64%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="14" align="center"&gt;&lt;b&gt;2017 Quarters&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;First&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Second&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Third&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Fourth&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net revenue&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;835,597&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;842,944&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;868,951&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;910,820&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Operating expenses:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice salaries and benefits&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;572,385&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;561,418&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;586,476&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;617,455&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice supplies and other operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27,796&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;30,872&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;29,497&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;32,353&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 General and administrative expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;103,765&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;103,015&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;101,430&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;108,895&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Depreciation and amortization&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;25,614&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;25,735&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;25,116&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;26,414&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;729,560&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;721,040&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;742,519&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;785,117&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income from operations&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;106,037&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;121,904&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;126,432&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;125,703&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Investment and other income&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;576&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;365&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;235&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,777&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Interest expense&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17,752&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(18,535&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(18,428&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(19,844&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Equity (losses) in earnings of unconsolidated affiliate&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;797&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;689&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(240&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(294&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total &lt;font style="WHITE-SPACE: nowrap"&gt;non-operating&lt;/font&gt;
 expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(16,379&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17,481&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(18,433&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17,361&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income before income taxes&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;89,658&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;104,423&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;107,999&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;108,342&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income tax (provision) benefit&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(34,967&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(40,725&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(42,119&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27,761&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income attributable to MEDNAX, Inc.&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;54,691&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;63,698&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;65,880&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;136,103&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Per common and common equivalent share data (1):&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income attributable to MEDNAX, Inc.:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.59&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.69&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.71&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1.47&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.59&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.69&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.71&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1.46&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Weighted average common shares:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,360&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,181&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,589&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,756&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,143&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,812&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,881&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,159&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="100%" border="0"&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top" width="4%" align="left"&gt;(1)&lt;/td&gt;
 &lt;td valign="top" align="left"&gt;Basic and diluted per share amounts
 are computed for each of the periods presented. Accordingly, the
 sum of the quarterly per share amounts may not agree with the full
 year amount.&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="100%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="64%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="14" align="center"&gt;&lt;b&gt;2016 Quarters&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;First&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Second&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Third&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Fourth&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net revenue&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;752,624&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;771,759&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;828,006&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;830,770&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Operating expenses:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice salaries and benefits&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;491,811&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;484,625&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;521,832&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;532,952&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice supplies and other operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27,046&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;26,992&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;31,641&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;32,737&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 General and administrative expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;89,950&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,116&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,457&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;97,049&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Depreciation and amortization&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;19,584&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;20,241&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;24,185&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;25,254&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;628,391&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;623,974&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;671,115&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;687,992&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income from operations&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;124,233&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;147,785&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;156,891&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;142,778&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Investment and other income&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;618&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;410&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;221&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;770&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Interest expense&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(14,463&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(15,058&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17,215&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(16,356&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Equity in earnings of unconsolidated affiliate&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;794&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;789&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;796&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;806&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total &lt;font style="WHITE-SPACE: nowrap"&gt;non-operating&lt;/font&gt;
 expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(13,051&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(13,859&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(16,198&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(14,780&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income before income taxes&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;111,182&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;133,926&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;140,693&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;127,998&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income tax provision&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(43,411&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(51,601&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(44,272&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(49,919&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;67,771&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;82,325&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;96,421&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;78,079&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net loss attributable to noncontrolling interests&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;128&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;102&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;88&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income attributable to MEDNAX, Inc.&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;67,899&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;82,427&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;96,509&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;78,079&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Per common and common equivalent share data (2):&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income attributable to MEDNAX, Inc.:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.74&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.89&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1.04&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.84&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.73&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.89&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1.04&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.84&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Weighted average common shares:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,269&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,182&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,604&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,728&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,091&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,945&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,146&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,347&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="100%" border="0"&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top" width="4%" align="left"&gt;(2)&lt;/td&gt;
 &lt;td valign="top" align="left"&gt;Basic and diluted per share amounts
 are computed for each of the periods presented. Accordingly, the
 sum of the quarterly per share amounts may not agree with the full
 year amount.&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfQuarterlyFinancialInformationTableTextBlock>
  <us-gaap:ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_6000203B-8C0A-4DB1-9291-A29001D956B2_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 The differences between the effective rate and the United States
 federal income tax statutory rate are as follows:&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="75%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Tax at statutory rate&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;35.00&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;35.00&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;35.00&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 State income tax, net of federal benefit&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;3.33&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2.94&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2.97&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 &lt;font style="WHITE-SPACE: nowrap"&gt;Non-deductible&lt;/font&gt;
 expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.49&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.43&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.34&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Change in accrual estimates relating to uncertain tax positions&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.02&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(2.11&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(0.43&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Change in valuation allowance&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.48&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.29&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Other, net&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.16&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.06&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(0.41&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Change in tax law&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17.06&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income tax provision&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;21.94&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;36.80&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;37.76&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock>
  <us-gaap:ScheduleOfRecognizedIdentifiedAssetsAcquiredAndLiabilitiesAssumedTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_6509A9C4-988F-42DC-92C3-21D1760A3169_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The
 Company&amp;#x2019;s preliminary allocation of purchase price is as
 follows (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="68%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="83%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Current assets&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;43,550&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Property and
 equipment&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;5,281&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Other noncurrent
 assets&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;52,611&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Goodwill&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;439,822&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Other intangible
 assets&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;39,414&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Current
 liabilities&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(5,674&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Other long-term
 liabilities&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(21,086&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;553,918&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfRecognizedIdentifiedAssetsAcquiredAndLiabilitiesAssumedTableTextBlock>
  <us-gaap:ScheduleOfSegmentReportingInformationBySegmentTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_E08EA69B-5B29-48C8-965E-3D7F97EEC2FD_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The following
 table summarizes the Company&amp;#x2019;s net revenue by service line
 (in percentages):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="75%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Years&amp;#xA0;Ended&amp;#xA0;December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Anesthesiology&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;38&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;39&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;37&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Neonatology and other
 pediatric subspecialties&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;37&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;39&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;44&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Maternal-fetal
 medicine&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;8&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;8&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;9&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Radiology and
 teleradiology&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;8&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;6&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;4&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Management
 services&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;6&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;5&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Pediatric
 cardiology&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;3&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;3&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;4&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;100&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;100&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;100&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfSegmentReportingInformationBySegmentTextBlock>
  <us-gaap:ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_1152434C-853C-4AD9-B17D-E98DDCE6E2AD_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The activity
 and certain other information related to the Company&amp;#x2019;s
 outstanding stock option awards for the year ended
 December&amp;#xA0;31, 2017 are as follows:&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="51%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Number&amp;#xA0;of&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Stock&amp;#xA0;
 Options&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Weighted&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Average&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Exercise&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Price&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Weighted&lt;br /&gt;
 Average&lt;br /&gt;
 Remaining&lt;br /&gt;
 Contractual&lt;br /&gt;
 Term&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;(in
 years)&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Aggregate&lt;br /&gt;
 Intrinsic&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Value&lt;/b&gt;&lt;/font&gt;&lt;br /&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;(in&amp;#xA0;millions)&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Outstanding at
 January&amp;#xA0;1, 2017&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;410,286&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;28.33&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Exercised&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(163,944&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;29.57&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;5.5&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Outstanding and exercisable
 at December&amp;#xA0;31, 2017&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;246,342&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;27.51&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1.5&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;6.4&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock>
  <us-gaap:ScheduleOfValuationAndQualifyingAccountsDisclosureTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_E0808C7C-F952-4F0E-8747-5FFF50A62541_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 24pt" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;MEDNAX, INC.&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 0pt" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Schedule II: Valuation and Qualifying
 Accounts&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="100%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="64%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Allowance for contractual adjustments and uncollectibles:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Balance at beginning of year&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,224,366&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,129,301&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;848,767&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Amount charged against operating revenue&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;8,285,317&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;7,464,030&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;6,389,195&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Accounts receivable contractual adjustments and write-offs (net of
 recoveries)&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(8,223,648&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(7,368,965&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(6,108,661&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Balance at end of year&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,286,035&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,224,366&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,129,301&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfValuationAndQualifyingAccountsDisclosureTextBlock>
  <us-gaap:SegmentReportingPolicyPolicyTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_CD097272-6381-49D1-8415-53EE96D532BE_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Segment
 Reporting&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The results of
 the Company&amp;#x2019;s operations are aggregated into a single
 reportable segment for purposes of presenting financial information
 in accordance with the accounting guidance for segment
 reporting.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The following
 table summarizes the Company&amp;#x2019;s net revenue by service line
 (in percentages):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="75%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Years&amp;#xA0;Ended&amp;#xA0;December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Anesthesiology&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;38&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;39&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;37&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Neonatology and other
 pediatric subspecialties&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;37&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;39&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;44&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Maternal-fetal
 medicine&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;8&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;8&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;9&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Radiology and
 teleradiology&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;8&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;6&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;4&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Management
 services&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;6&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;5&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Pediatric
 cardiology&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;3&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;3&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;4&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;100&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;100&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;100&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:SegmentReportingPolicyPolicyTextBlock>
  <us-gaap:ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_10738A66-10DD-43BD-9F04-D7BDF2EF0BCC_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Future minimum
 lease payments under &lt;font style="WHITE-SPACE: nowrap"&gt;non-cancelable&lt;/font&gt; operating leases as of
 December&amp;#xA0;31, 2017 are as follows (in
 thousands):&lt;b&gt;&amp;#xA0;&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="68%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="83%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2018&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;34,337&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2019&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;24,178&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2020&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;16,633&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2021&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;12,065&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2022&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;8,125&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Thereafter&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;9,934&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;105,272&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock>
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  <us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2 contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_8D3BFF0D-56E7-46C1-A9CB-77FA984A3D01_1_0">P1Y6M0D</us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2>
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  <us-gaap:ShareBasedCompensationOptionAndIncentivePlansPolicy contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_B27E3857-13D4-4CEE-9200-D473CDB004D7_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Stock Incentive
 Plans&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 grants stock-based awards consisting primarily of restricted stock
 to key employees under its Amended and Restated 2008 Incentive
 Compensation Plan, as amended. The Company measures the cost of
 employee services received in exchange for stock-based awards based
 on grant-date fair value and allocates the resulting compensation
 expense over the corresponding requisite service period using the
 graded vesting attribution method. The Company also performs
 analyses to estimate forfeitures of stock-based awards on an annual
 basis and adjusts the estimates as necessary based on the number of
 awards that ultimately vest.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:ShareBasedCompensationOptionAndIncentivePlansPolicy>
  <us-gaap:StateAndLocalIncomeTaxExpenseBenefitContinuingOperations contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_0E9BE689-87B3-4DA2-865B-045CEE0A9702_1_5">23035000</us-gaap:StateAndLocalIncomeTaxExpenseBenefitContinuingOperations>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="shares" decimals="INF" id="id_12960622_A78630B9-0D45-4BBB-A0AD-99A5331EB5F7_1_1">637529</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="shares" decimals="INF" id="id_12960622_A78630B9-0D45-4BBB-A0AD-99A5331EB5F7_1_3">451094</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_626D4F32-E94D-448A-8FB8-64E99C776812_1_0">29300000</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_12960622_45F6CA74-C8C9-4706-91BA-37C1ADF5575D_1_3">65.00</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_12960622_45F6CA74-C8C9-4706-91BA-37C1ADF5575D_1_2">64.82</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_12960622_6421FD8E-5122-47B9-B06E-1BD4143EE569_1_0">54.22</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_CF4CECA6-F41E-4FF8-867A-EF5CF11DA1B8_1_0">5500000</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue>
  <us-gaap:StockIssuedDuringPeriodSharesStockOptionsExercised contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="shares" decimals="INF" id="id_12960622_1EBA04D4-3797-46B9-94D5-7F4097C44C6E_1_1">-163944</us-gaap:StockIssuedDuringPeriodSharesStockOptionsExercised>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_BCB9E1E3-3F93-4849-BF44-77A2BE1613E8_9006_900037">23276000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation>
  <us-gaap:SignificantAccountingPoliciesTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_2BF88D07-B325-45AE-B531-886194584EA5_1_0">&lt;div&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="100%" border="0"&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top" width="4%" align="left"&gt;
 &lt;b&gt;2.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Summary&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="top" align="left"&gt;&lt;b&gt;of Significant Accounting
 Policies:&lt;/b&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt"&gt;
 &lt;b&gt;Principles of Presentation&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 The consolidated financial statements include all the accounts of
 the Company and its subsidiaries combined with the accounts of the
 affiliated professional contractors with which the Company
 currently has specific management arrangements. The Company&amp;#x2019;s
 agreements with affiliated professional contractors provide that
 the term of the arrangements are in most cases permanent, subject
 only to termination by the Company, except in the case of gross
 negligence, fraud or bankruptcy of the Company. The Company has the
 right to receive income, both as ongoing fees and as proceeds from
 the sale of its interest in the Company&amp;#x2019;s affiliated
 professional contractors, in an amount that fluctuates based on the
 performance of the affiliated professional contractors and the
 change in the fair value of the Company&amp;#x2019;s interest in the
 affiliated professional contractors. The Company has exclusive
 responsibility for the provision of all &lt;font style="WHITE-SPACE: nowrap"&gt;non-medical&lt;/font&gt; services required for the
 &lt;font style="WHITE-SPACE: nowrap"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;day-to-day&lt;/font&gt;&lt;/font&gt; operation and
 management of the Company&amp;#x2019;s affiliated professional
 contractors and establishes the guidelines for the employment and
 compensation of the physicians. In addition, the agreements provide
 that the Company has the right, but not the obligation, to
 purchase, or to designate a person(s) to purchase, the stock of the
 Company&amp;#x2019;s affiliated professional contractors for a nominal
 amount. Separately, in its sole discretion, the Company has the
 right to assign its interest in the agreements. Based upon the
 provisions of these agreements, the Company has determined that the
 affiliated professional contractors are variable interest entities
 and that the Company is the primary beneficiary as defined in the
 accounting guidance for consolidation. All significant intercompany
 and interaffiliate accounts and transactions have been
 eliminated.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 The Company is a partner in a joint venture in which it owns a
 37.5% economic interest. The Company accounts for this joint
 venture under the equity method of accounting because the Company
 exercises significant influence over, but does not control, this
 entity. On March&amp;#xA0;31, 2017, the Company sold its 75% economic
 interest in a second joint venture. The Company had a management
 agreement with the joint venture and, based on the terms of the
 agreement, the Company had determined that the joint venture was a
 variable interest entity for which the Company was the primary
 beneficiary. Accordingly, through the date of the sale, the
 financial results of the joint venture were fully consolidated into
 the Company&amp;#x2019;s operating results and the equity interests of
 the outside investor in the equity and results of operations of
 this consolidated entity were accounted for and presented as
 noncontrolling interests. See Note 6 for more information regarding
 the deconsolidation of this joint venture.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 18px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Recently Adopted
 Accounting Pronouncements&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In January
 2017, the accounting guidance related to goodwill impairment was
 amended to remove step two of the impairment test that requires a
 hypothetical purchase price allocation in order to measure the
 amount of any impairment. Under the new guidance, only a
 single-step quantitative test is required and any goodwill
 impairment will now be the amount by which a reporting unit&amp;#x2019;s
 carrying value exceeds its fair value. The new guidance does not
 amend the optional alternative to perform a qualitative assessment
 to determine if a quantitative goodwill impairment test is
 necessary. The Company early adopted this accounting guidance on
 December&amp;#xA0;31, 2017 as permitted. The adoption of this guidance
 did not have an impact on the Company&amp;#x2019;s Consolidated
 Financial Statements.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In January
 2017, the accounting guidance related to business combinations was
 amended to clarify the definition of a business. The Company early
 adopted this accounting guidance on December&amp;#xA0;31, 2017 as
 permitted. The adoption of this guidance did not have an impact on
 the Company&amp;#x2019;s Consolidated Financial Statements.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In August 2016
 and November 2016, the accounting guidance related to the statement
 of cash flows was amended with the intent of reducing diversity in
 practice as to the classification of certain transactions in the
 statement of cash flows. The Company early adopted this accounting
 guidance on December&amp;#xA0;31, 2017 as permitted. The adoption of
 this guidance resulted in the inclusion of restricted cash balances
 in the Company&amp;#x2019;s Consolidated Statements of Cash
 Flows.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In March 2016,
 the accounting guidance related to various aspects of share-based
 payment transactions was amended, including income tax
 consequences, classification of awards as either equity or
 liabilities, and classification on the statement of cash flows.
 Under the new guidance, excess tax benefits and deficiencies are to
 be recognized as income tax benefits or expenses in the income
 statement as discrete items in the reporting period in which they
 occur instead of increases or decreases to shareholders&amp;#x2019;
 equity. Excess tax benefits should be classified along with other
 income tax cash flows as operating activities. With regard to
 forfeitures, the entity may make an entity-wide accounting policy
 election to either estimate the number of awards that are expected
 to vest or account for forfeitures when they occur. This guidance
 became effective for the Company on January&amp;#xA0;1, 2017. The
 Company adopted this guidance prospectively for both the income
 statement and statement of cash flows, and the adoption of this
 guidance did not have a material impact on the Company&amp;#x2019;s
 Consolidated Financial Statements. The Company continues to
 estimate forfeitures based on the number of awards that are
 expected to vest.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;New Accounting
 Pronouncements&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In February
 2016, the accounting guidance related to leases was issued that
 will require an entity to recognize leased assets and the rights
 and obligations created by those leased assets on the balance sheet
 and to disclose key information about the entity&amp;#x2019;s leasing
 arrangements. This guidance will become effective for the Company
 on January&amp;#xA0;1, 2019, with early adoption permitted. The Company
 expects that the adoption of this guidance will have a material
 impact on its Consolidated Balance Sheets and related disclosures,
 resulting from the recognition of significant right of use assets
 and related liabilities primarily related to its operating lease
 arrangements for space in hospitals and certain other facilities
 for its business and medical offices. The Company is in the process
 of reviewing its existing lease portfolio and accumulating all of
 the necessary information required to properly account for leases
 under the new guidance.&amp;#xA0;Additionally, the Company is assessing
 system requirements, required changes to its processes and internal
 control implications to ensure the Company will meet the reporting
 and disclosure requirements. The Company&amp;#x2019;s evaluation of this
 guidance and its impacts are expected to continue through the third
 quarter of 2018.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In May 2014,
 the accounting guidance related to revenue recognition was amended
 to outline a single, comprehensive model for accounting for revenue
 from contracts with customers. The core principle of the new
 accounting guidance is to require an entity to recognize as revenue
 the amount that reflects the consideration to which it expects to
 be entitled in exchange for goods or services as it transfers
 control to its customers.&amp;#xA0;The new guidance will become
 effective for the Company on January&amp;#xA0;1, 2018. The
 Company&amp;#x2019;s current revenue recognition policies for its
 significant revenue streams materially comply with the amended
 guidance. The primary change for healthcare providers under the new
 guidance is the requirement to report the allowance for
 uncollectibles associated with patient responsibility amounts as a
 reduction in net revenue as opposed to bad debt expense as a
 component of operating expenses. The Company has historically
 included the allowance for uncollectibles associated with patient
 responsibility amounts with its allowance for contractual
 adjustments as a reduction in net revenue as such amounts are not
 material. Accordingly, the adoption of this guidance will not have
 an impact on our Consolidated Financial Statements.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Accounting Estimates and
 Assumptions&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The preparation
 of financial statements in conformity with accounting principles
 generally accepted in the United States (&amp;#x201C;GAAP&amp;#x201D;)
 requires management to make estimates and assumptions that affect
 the reported amounts of assets and liabilities and disclosure of
 contingent assets and liabilities at the date of the financial
 statements and the reported amounts of revenue and expenses during
 the reporting periods. Significant estimates and assumptions are
 involved in the calculation of the Company&amp;#x2019;s allowance for
 contractual adjustments and uncollectibles on accounts receivable,
 liabilities for self- insured amounts and claims incurred but not
 reported related to the Company&amp;#x2019;s professional liability
 risks and the fair value of goodwill. Actual results could differ
 from those estimates.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Segment
 Reporting&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The results of
 the Company&amp;#x2019;s operations are aggregated into a single
 reportable segment for purposes of presenting financial information
 in accordance with the accounting guidance for segment
 reporting.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The following
 table summarizes the Company&amp;#x2019;s net revenue by service line
 (in percentages):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="75%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Years&amp;#xA0;Ended&amp;#xA0;December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Anesthesiology&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;38&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;39&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;37&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Neonatology and other
 pediatric subspecialties&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;37&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;39&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;44&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Maternal-fetal
 medicine&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;8&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;8&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;9&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Radiology and
 teleradiology&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;8&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;6&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;4&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Management
 services&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;6&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;5&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Pediatric
 cardiology&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;3&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;3&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;4&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;100&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;100&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;100&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;%&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Revenue
 Recognition&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Patient service
 revenue is recognized at the time services are provided by the
 Company&amp;#x2019;s affiliated physicians. Almost all of the
 Company&amp;#x2019;s patient service revenue is reimbursed by
 government-sponsored healthcare programs and third-party insurance
 payors. Payments for services rendered to the Company&amp;#x2019;s
 patients are generally less than billed charges. The Company
 monitors its revenue and receivables from these sources and records
 an estimated contractual allowance to properly account for the
 anticipated differences between billed and reimbursed
 amounts.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Accordingly,
 patient service revenue is presented net of an estimated provision
 for contractual adjustments and uncollectibles. The Company
 estimates allowances for contractual adjustments and uncollectibles
 on accounts receivable based upon historical experience and other
 factors, including days sales outstanding (&amp;#x201C;DSO&amp;#x201D;) for
 accounts receivable, evaluation of expected adjustments and
 delinquency rates, past adjustments and collection experience in
 relation to amounts billed, an aging of accounts receivable,
 current contract and reimbursement terms, changes in payor mix and
 other relevant information. Contractual adjustments result from the
 difference between the physician rates for services performed and
 the reimbursements by government-sponsored healthcare programs and
 insurance companies for such services.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In addition,
 the Company generates revenue for services rendered under various
 coding and billing contracts. Contract terms are specific to each
 customer and may include a combination of a flat fee for coding of
 medical charts, a fixed fee per patient visit as well as a
 percentage of cash collections received by the providers. Revenue
 for flat and fixed fee arrangements is recognized in the month the
 coding occurs or the patient visit occurs. Revenue for percentage
 fees are recognized in the month that cash is collected for
 customers from payors. Revenue recorded for these services during
 2017 were immaterial.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Accounts
 receivable are primarily amounts due under &lt;font style="WHITE-SPACE: nowrap"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;fee-for-service&lt;/font&gt;&lt;/font&gt; contracts from
 third-party payors, such as insurance companies, self-insured
 employers and patients and government-sponsored healthcare programs
 geographically dispersed throughout the United States and its
 territories. Concentration of credit risk relating to accounts
 receivable is limited by the number, diversity and geographic
 dispersion of the business units managed by the Company, as well as
 by the large number of patients and payors, including the various
 governmental agencies in the states in which the Company provides
 services. Receivables from government agencies made up
 approximately 17% of net accounts receivable at December&amp;#xA0;31,
 2017 and 2016.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Cash and Cash
 Equivalents&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Cash
 equivalents are defined as all highly liquid financial instruments
 with maturities of 90 days or less from the date of purchase. The
 Company&amp;#x2019;s cash equivalents typically consist of demand
 deposits, amounts on deposit in money market accounts, and funds
 invested in overnight repurchase agreements. Cash equivalent
 balances may, at certain times, exceed federally insured
 limits.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Certain cash
 equivalents carried by the Company are subject to the fair value
 provisions of the accounting guidance for fair value measurements.
 See &amp;#x201C;Fair Value Measurements&amp;#x201D; below.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Restricted
 Cash&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Restricted cash
 consists of funds in escrow related to a potential future payment
 for contingent consideration for an acquisition completed during
 the year ended December&amp;#xA0;31, 2017. See Note 6 for more
 information regarding the underlying contingent consideration
 arrangement.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Investments&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Investments
 consist of municipal debt securities, federal home loan securities
 and certificates of deposit. Investments with remaining maturities
 of less than one year are classified as short-term investments.
 Investments classified as long-term have maturities of one year to
 six years.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 intends and has the ability to hold its securities to maturity, and
 therefore carries such investments at amortized cost in accordance
 with the provisions of the accounting guidance for investments in
 debt securities.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Property and
 Equipment&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Property and
 equipment are recorded at original purchase cost. Depreciation of
 property and equipment is computed using the straight-line method
 over the estimated useful lives of the underlying assets. Estimated
 useful lives are generally 30 years for buildings; three to seven
 years for medical equipment, computer equipment, software and
 furniture; and the lesser of the useful life or the remaining lease
 term for leasehold improvements and capital leases. Upon sale or
 retirement of property and equipment, the related cost and
 accumulated depreciation are eliminated from the respective
 accounts and any resulting gain or loss is included in
 earnings.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Business
 Acquisitions&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 accounts for all business acquisitions at fair value and expenses
 acquisition costs as they are incurred. Any identifiable assets
 acquired and liabilities assumed are recognized and measured at
 their respective fair values on the acquisition date. If
 information about facts and circumstances existing as of the
 acquisition date is incomplete at the end of the reporting period
 in which a business acquisition occurs, the Company will report
 provisional amounts for the items for which the accounting is
 incomplete. The measurement period ends once the Company receives
 sufficient information to finalize the fair values; however, the
 period will not exceed one year from the acquisition date. Prior to
 January&amp;#xA0;1, 2016, any material adjustments recognized during
 the measurement period were required to be reflected
 retrospectively in the Consolidated Financial Statements of the
 subsequent period. Beginning on January&amp;#xA0;1, 2016, any
 adjustments to provisional amounts that are identified during the
 measurement period are required to be recognized in the reporting
 period in which the adjustment amounts are determined.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In connection
 with certain acquisitions, the Company enters into agreements to
 pay additional amounts in cash or common stock based on the
 achievement of certain performance measures for up to five years
 ending after the acquisition dates. The Company measures this
 contingent consideration at fair value at the acquisition date and
 records such contingent consideration as a liability or equity on
 the Company&amp;#x2019;s Consolidated Balance Sheets on the acquisition
 date. The fair value of each contingent consideration liability is
 remeasured at each reporting period with any change in fair value
 recognized as income or expense within operations in the
 Company&amp;#x2019;s Consolidated Statements of Income. See Note 6 for
 more information on the Company&amp;#x2019;s business
 acquisitions.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Goodwill and Other
 Intangible Assets&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 records acquired assets and assumed liabilities at their respective
 fair values under the acquisition method of accounting. Goodwill
 represents the excess of purchase price over the fair value of the
 net assets acquired. Intangible assets with finite lives,
 principally physician and hospital agreements, customer
 relationships, patented technology and trade names, are recognized
 apart from goodwill at the time of acquisition based on the
 contractual-legal and separability criteria established in the
 accounting guidance. Intangible assets with finite lives are
 amortized on either an accelerated basis based on the annual
 undiscounted economic cash flows associated with the particular
 intangible asset or on a straight-line basis over their estimated
 useful lives. Intangible assets with finite lives are amortized
 over periods of one to 20 years.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Goodwill is
 tested for impairment at a reporting unit level on at least an
 annual basis in accordance with the subsequent measurement
 provisions of the accounting guidance for goodwill. The Company
 defines a reporting unit based upon its management structure for
 services provided in specific regions of the United States. The
 Company early adopted new accounting guidance in 2017 that requires
 only a single-step quantitative test with any goodwill impairment
 measured as the amount by which a reporting unit&amp;#x2019;s carrying
 value exceeds its fair value. The Company uses income and
 market-based valuation approaches to determine the fair value of
 its reporting units. These approaches focus on discounted cash
 flows and market multiples based on the Company&amp;#x2019;s market
 capitalization to derive the fair value of a reporting unit. The
 Company also considers the economic outlook for the healthcare
 services industry and various other factors during the testing
 process, including hospital and physician contract changes, local
 market developments, changes in third-party payor payments, and
 other publicly available information. The Company completed annual
 impairment tests in the third quarter of each of 2017, 2016 and
 2015 and determined that goodwill was not impaired in any of the
 three years.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 18px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Long-Lived
 Assets&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company is
 required to evaluate long-lived assets, including intangible assets
 subject to amortization, whenever events or changes in
 circumstances indicate that the carrying value of the assets may
 not be fully recoverable. The recoverability of such assets is
 measured by a comparison of the carrying value of the assets to the
 future undiscounted cash flows before interest charges to be
 generated by the assets. If long-lived assets are impaired, the
 impairment to be recognized is measured as the excess of the
 carrying value over the fair value. Long-lived assets held for
 disposal are reported at the lower of the carrying value or fair
 value less disposal costs. The Company does not believe there are
 any indicators that would require an adjustment to such assets or
 their estimated periods of recovery at December&amp;#xA0;31, 2017
 pursuant to current accounting standards.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Common Stock
 Repurchases&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 repurchases shares of its common stock as authorized from time to
 time by its Board of Directors. The Company treats repurchased
 shares of its common stock as retired as any repurchased shares
 become authorized but unissued shares. The reacquisition cost of
 repurchased shares is recorded as a reduction in the respective
 components of shareholders&amp;#x2019; equity.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Professional Liability
 Coverage&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 maintains professional liability insurance policies with
 third-party insurers generally on a claims-made basis, subject to
 deductibles or self-insured retention, exclusions and other
 restrictions. The Company&amp;#x2019;s self-insured retention under its
 professional liability insurance program is maintained primarily
 through a wholly owned captive insurance subsidiary. The Company
 records an estimate of liabilities for self-insured amounts and
 claims incurred but not reported based on an actuarial valuation
 using historical loss information, claim emergence patterns and
 various actuarial assumptions. Liabilities for claims incurred but
 not reported are not discounted.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Income
 Taxes&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 records deferred income taxes using the liability method, whereby
 deferred tax assets and liabilities are determined based on the
 difference between the financial statement and tax bases of assets
 and liabilities using enacted tax rates in effect for the year in
 which the differences are expected to reverse. If it is more likely
 than not that all or a portion of deferred tax assets will not be
 realized, a valuation allowance is provided against such deferred
 tax assets. In making such determination, the Company considers all
 available positive and negative evidence, including future
 reversals of existing taxable temporary differences, projected
 future taxable income, &lt;font style="WHITE-SPACE: nowrap"&gt;tax-planning&lt;/font&gt; strategies, and results
 of recent operations.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The accounting
 guidance for uncertain tax positions prescribes a recognition
 threshold and measurement attribute for financial statement
 recognition and measurement of a tax position taken or expected to
 be taken in a tax return. The guidance also requires policy
 disclosures regarding penalties and interest and extensive
 disclosures regarding increases and decreases in uncertain tax
 positions as a result of tax positions taken in a current or prior
 period, settlements with taxing authorities and any lapse of an
 applicable statute of limitations. Additional qualitative
 discussion is required for any tax position that may result in a
 significant increase or decrease in uncertain tax positions within
 a &lt;font style="WHITE-SPACE: nowrap"&gt;12-month&lt;/font&gt; period from the
 Company&amp;#x2019;s reporting date.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Stock Incentive
 Plans&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 grants stock-based awards consisting primarily of restricted stock
 to key employees under its Amended and Restated 2008 Incentive
 Compensation Plan, as amended. The Company measures the cost of
 employee services received in exchange for stock-based awards based
 on grant-date fair value and allocates the resulting compensation
 expense over the corresponding requisite service period using the
 graded vesting attribution method. The Company also performs
 analyses to estimate forfeitures of stock-based awards on an annual
 basis and adjusts the estimates as necessary based on the number of
 awards that ultimately vest.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 18px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Net Income Per Common
 Share&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Basic net
 income per common share is calculated by dividing net income by the
 weighted average number of common shares outstanding during the
 period. Diluted net income per common share is calculated by
 dividing net income by the weighted average number of common and
 potential common shares outstanding during the period. Potential
 common shares consist of outstanding restricted stock, deferred
 stock and stock options and is calculated using the treasury stock
 method. On January&amp;#xA0;1, 2017, the Company adopted new accounting
 guidance that no longer permits the Company to include the assumed
 excess tax benefits related to the potential exercise or vesting of
 its stock-based awards in the treasury stock method computation.
 The impact on the weighted average number of common and common
 equivalent shares outstanding from excluding such assumed excess
 tax benefits for the year ended December&amp;#xA0;31, 2017 was not
 material. See &amp;#x201C;Recently Adopted Accounting
 Pronouncements&amp;#x201D; above for additional information on the
 adoption of the new accounting guidance.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Fair Value
 Measurements&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In accordance
 with the accounting guidance for fair value measurements and
 disclosures, the Company carries its money market funds included in
 cash and cash equivalents at fair value. In accordance with the
 three-tier fair value hierarchy under this guidance, the Company
 determined the fair value using quoted market prices, a
 Level&amp;#xA0;1 input as defined under the accounting guidance for
 fair value measurements. At December&amp;#xA0;31, 2017 and 2016, the
 Company&amp;#x2019;s money market funds had a fair value of
 $9.2&amp;#xA0;million and $12.4&amp;#xA0;million, respectively.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 also carries the cash surrender value of life insurance related to
 its deferred compensation arrangements at fair value. The
 investments underlying the life insurance contracts consist
 primarily of exchange-traded equity securities and mutual funds
 with quoted prices in active markets. In accordance with the
 three-tier fair value hierarchy, the Company determined the fair
 value using the cash surrender value of the life insurance, a
 Level&amp;#xA0;2 input as defined under the accounting guidance for
 fair value measurements. At December&amp;#xA0;31, 2017 and 2016, the
 Company&amp;#x2019;s cash surrender value of life insurance had a fair
 value of $15.6&amp;#xA0;million and $15.8&amp;#xA0;million,
 respectively.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In addition,
 the Company carries its contingent consideration liabilities
 related to acquisitions at fair value. In accordance with the
 three-tier fair value hierarchy, the Company determined the fair
 value of its contingent consideration liabilities using the income
 approach with assumed discount rates and payment probabilities. The
 income approach uses Level&amp;#xA0;3, or unobservable inputs as
 defined under the accounting guidance for fair value measurements.
 At December&amp;#xA0;31, 2017 and 2016, the Company&amp;#x2019;s contingent
 consideration liabilities had a fair value of $30.5&amp;#xA0;million
 and $17.3&amp;#xA0;million, respectively. See Note 6 for more
 information regarding the Company&amp;#x2019;s contingent consideration
 liabilities.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The carrying
 amounts of cash equivalents, short-term investments, accounts
 receivable and accounts payable and accrued expenses approximate
 fair value due to the short maturities of the respective
 instruments. The carrying values of long-term investments, line of
 credit, variable rate long-term debt and capital lease obligations
 approximate fair value. If the Company&amp;#x2019;s investments were
 measured at fair value, they would be categorized as Level&amp;#xA0;2
 in the fair value hierarchy. If the Company&amp;#x2019;s line of credit
 and variable long-term debt were measured at fair value, they would
 be categorized as Level&amp;#xA0;2 in the fair value hierarchy. See
 Note 10 for information regarding the fair value of the
 Company&amp;#x2019;s 5.25% senior unsecured notes due 2023 (the
 &amp;#x201C;2023 Notes&amp;#x201D;).&lt;/font&gt;&lt;/p&gt;
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 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The following
 table summarizes the activity related to the Company&amp;#x2019;s
 liability for uncertain tax positions for the years ended
 December&amp;#xA0;31, 2017, 2016 and 2015 (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="66%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Balance at beginning of
 year&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;9,469&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;18,447&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;17,165&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Increases related to prior
 year tax positions&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2,284&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;301&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;467&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Decreases related to prior
 year tax positions&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(143&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(3,927&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(1,168&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Increases related to
 current year tax positions&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,430&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;2,258&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;3,675&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Settlements&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(5,644&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Decreases related to lapse
 of statutes of limitation&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(2,068&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(1,966&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(1,692&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Balance at end of
 year&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;10,972&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;9,469&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;18,447&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</us-gaap:SummaryOfIncomeTaxContingenciesTextBlock>
  <us-gaap:UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_31FC4D84-1B4D-481C-8576-84696072401D_1_2">143000</us-gaap:UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions>
  <dei:TradingSymbol contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_6B6A89F4-5FCF-4B5C-912E-DF8AAA83141B_1_0">MD</dei:TradingSymbol>
  <us-gaap:UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_31FC4D84-1B4D-481C-8576-84696072401D_1_1">2284000</us-gaap:UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions>
  <us-gaap:UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_31FC4D84-1B4D-481C-8576-84696072401D_1_5">2068000</us-gaap:UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations>
  <us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="shares" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_22">92958000</us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding>
  <us-gaap:UnrecognizedTaxBenefitsPeriodIncreaseDecrease contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_190C0E09-27C8-4756-A686-43FEF94A134D_1_0">1500000</us-gaap:UnrecognizedTaxBenefitsPeriodIncreaseDecrease>
  <us-gaap:ValuationAllowancesAndReservesAdjustments contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="0" id="id_12960622_4914FF49-F675-45B1-9DD2-74F329485259_1_2">-8223648</us-gaap:ValuationAllowancesAndReservesAdjustments>
  <us-gaap:ValuationAllowancesAndReservesChargedToCostAndExpense contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="0" id="id_12960622_4914FF49-F675-45B1-9DD2-74F329485259_1_1">8285317</us-gaap:ValuationAllowancesAndReservesChargedToCostAndExpense>
  <us-gaap:UseOfEstimates contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_8A32F6B2-4E43-49C2-ACCA-E59599B8AE5E_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Accounting Estimates and
 Assumptions&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The preparation
 of financial statements in conformity with accounting principles
 generally accepted in the United States (&amp;#x201C;GAAP&amp;#x201D;)
 requires management to make estimates and assumptions that affect
 the reported amounts of assets and liabilities and disclosure of
 contingent assets and liabilities at the date of the financial
 statements and the reported amounts of revenue and expenses during
 the reporting periods. Significant estimates and assumptions are
 involved in the calculation of the Company&amp;#x2019;s allowance for
 contractual adjustments and uncollectibles on accounts receivable,
 liabilities for self- insured amounts and claims incurred but not
 reported related to the Company&amp;#x2019;s professional liability
 risks and the fair value of goodwill. Actual results could differ
 from those estimates.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</us-gaap:UseOfEstimates>
  <us-gaap:WeightedAverageNumberOfSharesOutstandingBasic contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="shares" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_21">92431000</us-gaap:WeightedAverageNumberOfSharesOutstandingBasic>
  <md:PracticeSalariesAndBenefits contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_2">2337734000</md:PracticeSalariesAndBenefits>
  <md:ProvisionAdjustmentForLossesRelatedToPriorYear contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_6DED415F-A549-49CA-8D83-9DC6D6B4D6B9_1_3">9983000</md:ProvisionAdjustmentForLossesRelatedToPriorYear>
  <md:ProvisionAdjustmentForLossesRelatedToCurrentYear contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_6DED415F-A549-49CA-8D83-9DC6D6B4D6B9_1_2">41291000</md:ProvisionAdjustmentForLossesRelatedToCurrentYear>
  <md:ContractualAdjustmentsAndUncollectibles contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_270FFCF1-FAB6-4752-9980-6647C19E4D88_1_1">8285317000</md:ContractualAdjustmentsAndUncollectibles>
  <md:PracticeSuppliesAndOtherOperatingExpenses contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_3BDB8224-D77F-44F3-80A4-519BCF94F62C_1_3">120518000</md:PracticeSuppliesAndOtherOperatingExpenses>
  <md:HealthOrganizationRevenueGross contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_270FFCF1-FAB6-4752-9980-6647C19E4D88_1_0">11427238000</md:HealthOrganizationRevenueGross>
  <md:MalpracticeLossContingencyProvisionForLosses contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_6DED415F-A549-49CA-8D83-9DC6D6B4D6B9_1_4">51274000</md:MalpracticeLossContingencyProvisionForLosses>
  <md:AccruedProfessionalLiabilitiesAssumedThroughAcquisition contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_6DED415F-A549-49CA-8D83-9DC6D6B4D6B9_1_1">20716000</md:AccruedProfessionalLiabilitiesAssumedThroughAcquisition>
  <md:StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_BCB9E1E3-3F93-4849-BF44-77A2BE1613E8_9006_900041">2658000</md:StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration>
  <md:HospitalContractAdministrativeFees contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_12960622_270FFCF1-FAB6-4752-9980-6647C19E4D88_1_2">316391000</md:HospitalContractAdministrativeFees>
  <md:CashAndCashEquivalentsMaturityDescription contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_0263C5CA-F7BF-4885-826B-7592150474F8_1_0">90</md:CashAndCashEquivalentsMaturityDescription>
  <md:NumberOfPhysicianGroupPracticesAcquired contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="Company" decimals="INF" id="id_12960622_C795A629-E311-4179-965D-2E2D3C59C2DD_1_0">10</md:NumberOfPhysicianGroupPracticesAcquired>
  <md:NumberOfMaternalfetalMedicinePracticesAcquired contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="Company" decimals="INF" id="id_12960622_C795A629-E311-4179-965D-2E2D3C59C2DD_1_2">2</md:NumberOfMaternalfetalMedicinePracticesAcquired>
  <md:NumberOfPediatricSubspecialtyPracticesAcquired contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="Company" decimals="INF" id="id_12960622_C795A629-E311-4179-965D-2E2D3C59C2DD_1_3">2</md:NumberOfPediatricSubspecialtyPracticesAcquired>
  <md:NumberOfRadiologyPracticesAcquired contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="Company" decimals="INF" id="id_12960622_C795A629-E311-4179-965D-2E2D3C59C2DD_1_5">4</md:NumberOfRadiologyPracticesAcquired>
  <md:NumberOfNeonatologyPracticesAcquired contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="Company" decimals="INF" id="id_12960622_C795A629-E311-4179-965D-2E2D3C59C2DD_1_1">1</md:NumberOfNeonatologyPracticesAcquired>
  <md:BusinessCombinationContingentConsiderationArrangementsTimePeriod contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_DCD796DB-B7C8-448A-A5BE-B18A4DCFD95B_1_0">P5Y</md:BusinessCombinationContingentConsiderationArrangementsTimePeriod>
  <md:BusinessCombinationDispositionOrAssignmentRestrictionPeriod contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_F1BA568E-3FEF-47ED-A02C-5A326FA27ADA_1_2">P3Y</md:BusinessCombinationDispositionOrAssignmentRestrictionPeriod>
  <md:ScheduleOfCapitalLeaseObligationsTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_02F21649-1F4D-473B-B1A5-12E6CA7A338F_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The
 Company&amp;#x2019;s capital lease obligations consist of the following
 (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="75%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="6" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Capital lease
 obligations&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,826&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;3,550&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Less: Current
 portion&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(1,401&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(2,054&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Long-term
 portion&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;425&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;1,496&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</md:ScheduleOfCapitalLeaseObligationsTableTextBlock>
  <md:ProfessionalLiabilityCoveragePolicyTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_B5C720F1-21CA-4838-850A-62F64A3A3D59_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Professional Liability
 Coverage&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 maintains professional liability insurance policies with
 third-party insurers generally on a claims-made basis, subject to
 deductibles or self-insured retention, exclusions and other
 restrictions. The Company&amp;#x2019;s self-insured retention under its
 professional liability insurance program is maintained primarily
 through a wholly owned captive insurance subsidiary. The Company
 records an estimate of liabilities for self-insured amounts and
 claims incurred but not reported based on an actuarial valuation
 using historical loss information, claim emergence patterns and
 various actuarial assumptions. Liabilities for claims incurred but
 not reported are not discounted.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</md:ProfessionalLiabilityCoveragePolicyTextBlock>
  <md:CommonStockRepurchasesTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_996B138B-7ABD-4043-8C8C-463D66756D5E_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;14.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Common Stock Repurchase
 Programs:&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In July 2013,
 the Company&amp;#x2019;s Board of Directors authorized the repurchase of
 shares of the Company&amp;#x2019;s common stock up to an amount
 sufficient to offset the dilutive impact from the issuance of
 shares under the Company&amp;#x2019;s equity compensation programs. The
 share repurchase program allows the Company to make open market
 purchases from &lt;font style="WHITE-SPACE: nowrap"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;time-to-time&lt;/font&gt;&lt;/font&gt; based on general
 economic and market conditions and trading restrictions. The
 repurchase program also allows for the repurchase of shares of the
 Company&amp;#x2019;s common stock to offset the dilutive impact from the
 issuance of shares, if any, related to the Company&amp;#x2019;s
 acquisition program.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;During the year
 ended December&amp;#xA0;31, 2017, the Company repurchased
 1.0&amp;#xA0;million shares of its common stock for $70.2&amp;#xA0;million,
 inclusive of 38,257 shares withheld to satisfy minimum statutory
 withholding obligations of $2.1&amp;#xA0;million in connection with the
 vesting of restricted stock.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In October
 2014, the Company&amp;#x2019;s Board of Directors authorized the
 repurchase of up to $600.0&amp;#xA0;million of shares of the
 Company&amp;#x2019;s common stock in addition to its existing share
 repurchase program.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In December
 2014, the Company entered into an uncollared accelerated share
 repurchase (&amp;#x201C;ASR&amp;#x201D;) agreement with an investment bank.
 Under the ASR agreement, the Company agreed to purchase
 $200.0&amp;#xA0;million of its common stock in total. On
 December&amp;#xA0;17, 2014, the Company paid a total of
 $200.0&amp;#xA0;million to an investment bank, which in turn delivered
 to the Company 2.5&amp;#xA0;million shares of the Company&amp;#x2019;s
 common stock in total based on the market price of a share of
 Company common stock on December&amp;#xA0;12, 2014. The payment was
 recorded as a reduction to the respective components of
 shareholders&amp;#x2019; equity. The final number of shares of common
 stock that the Company may receive, or may be required to remit,
 upon settlement under the ASR agreement was to be based upon the
 average daily volume weighted-average price of the Company&amp;#x2019;s
 common stock during the term of the ASR agreement, less a
 negotiated discount. The ASR agreement was funded by borrowings
 under the Company&amp;#x2019;s Credit Agreement discussed in Note 10.
 Final settlement of the ASR occurred in July 2015 with the delivery
 to the Company of 0.3&amp;#xA0;million additional shares of common
 stock. The final number of shares of common stock that the Company
 received was based upon the average daily volume weighted-average
 price of the Company&amp;#x2019;s common stock during the term of the
 ASR agreement, less a negotiated discount.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In March 2015,
 the Company entered into a second uncollared ASR agreement with an
 investment bank. Under the ASR agreement, the Company agreed to
 purchase $200.0&amp;#xA0;million of its common stock in total. On
 March&amp;#xA0;16, 2015, the Company paid a total of
 $200.0&amp;#xA0;million to an investment bank, which in turn delivered
 to the Company 2.2&amp;#xA0;million shares of the Company&amp;#x2019;s
 common stock in total based on the market price of a share of
 Company common stock on March&amp;#xA0;12, 2015. The ASR agreement was
 funded by borrowings under the Company&amp;#x2019;s Credit Agreement,
 and the payment was recorded as a reduction to the respective
 components of shareholders&amp;#x2019; equity. Final settlement of the
 ASR occurred in October 2015 with the delivery to the Company of
 0.3&amp;#xA0;million additional shares of common stock. The final
 number of shares of common stock that the Company received was
 based upon the average daily volume weighted-average price of the
 Company&amp;#x2019;s common stock during the term of the ASR agreement,
 less a negotiated discount.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;During the year
 ended December&amp;#xA0;31, 2016, the Company repurchased
 0.9&amp;#xA0;million shares of its common stock for $61.8&amp;#xA0;million,
 inclusive of 46,490 shares withheld to satisfy minimum stock
 withholding obligations of $3.2&amp;#xA0;million in connection with the
 vesting of restricted stock.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 intends to utilize various methods to effect any future share
 repurchases, including, among others, open market purchases and
 accelerated share repurchase programs. The amount and timing of
 repurchases will depend upon several factors, including general
 economic and market conditions and trading restrictions.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</md:CommonStockRepurchasesTextBlock>
  <md:CommonStockShareRepurchasesPolicyTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_98EFB162-B1EB-4C3F-9599-F65B835FA471_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Common Stock
 Repurchases&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The Company
 repurchases shares of its common stock as authorized from time to
 time by its Board of Directors. The Company treats repurchased
 shares of its common stock as retired as any repurchased shares
 become authorized but unissued shares. The reacquisition cost of
 repurchased shares is recorded as a reduction in the respective
 components of shareholders&amp;#x2019; equity.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</md:CommonStockShareRepurchasesPolicyTextBlock>
  <md:RecentlyAdoptedAccountingPronouncementsPolicyTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_CBA594B1-D83E-456E-BC88-A762466008AA_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&lt;b&gt;Recently Adopted
 Accounting Pronouncements&lt;/b&gt;&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In January
 2017, the accounting guidance related to goodwill impairment was
 amended to remove step two of the impairment test that requires a
 hypothetical purchase price allocation in order to measure the
 amount of any impairment. Under the new guidance, only a
 single-step quantitative test is required and any goodwill
 impairment will now be the amount by which a reporting unit&amp;#x2019;s
 carrying value exceeds its fair value. The new guidance does not
 amend the optional alternative to perform a qualitative assessment
 to determine if a quantitative goodwill impairment test is
 necessary. The Company early adopted this accounting guidance on
 December&amp;#xA0;31, 2017 as permitted. The adoption of this guidance
 did not have an impact on the Company&amp;#x2019;s Consolidated
 Financial Statements.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In January
 2017, the accounting guidance related to business combinations was
 amended to clarify the definition of a business. The Company early
 adopted this accounting guidance on December&amp;#xA0;31, 2017 as
 permitted. The adoption of this guidance did not have an impact on
 the Company&amp;#x2019;s Consolidated Financial Statements.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In August 2016
 and November 2016, the accounting guidance related to the statement
 of cash flows was amended with the intent of reducing diversity in
 practice as to the classification of certain transactions in the
 statement of cash flows. The Company early adopted this accounting
 guidance on December&amp;#xA0;31, 2017 as permitted. The adoption of
 this guidance resulted in the inclusion of restricted cash balances
 in the Company&amp;#x2019;s Consolidated Statements of Cash
 Flows.&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;In March 2016,
 the accounting guidance related to various aspects of share-based
 payment transactions was amended, including income tax
 consequences, classification of awards as either equity or
 liabilities, and classification on the statement of cash flows.
 Under the new guidance, excess tax benefits and deficiencies are to
 be recognized as income tax benefits or expenses in the income
 statement as discrete items in the reporting period in which they
 occur instead of increases or decreases to shareholders&amp;#x2019;
 equity. Excess tax benefits should be classified along with other
 income tax cash flows as operating activities. With regard to
 forfeitures, the entity may make an entity-wide accounting policy
 election to either estimate the number of awards that are expected
 to vest or account for forfeitures when they occur. This guidance
 became effective for the Company on January&amp;#xA0;1, 2017. The
 Company adopted this guidance prospectively for both the income
 statement and statement of cash flows, and the adoption of this
 guidance did not have a material impact on the Company&amp;#x2019;s
 Consolidated Financial Statements. The Company continues to
 estimate forfeitures based on the number of awards that are
 expected to vest.&lt;/font&gt;&lt;/p&gt;
 &lt;/div&gt;</md:RecentlyAdoptedAccountingPronouncementsPolicyTextBlock>
  <md:ScheduleOfAccruedProfessionalLiabilityTableTextBlock contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" id="id_12960622_6C66E76A-3F89-4FA9-A1D5-22405DC12D4C_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%"&gt;
 &lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;The activity
 related to the Company&amp;#x2019;s total accrued professional liability
 for the years ended December&amp;#xA0;31, 2017, 2016 and 2015 is as
 follows (in thousands):&lt;/font&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="63%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="1"&gt;&lt;b&gt;2015&lt;/b&gt;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Balance at beginning of
 year&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;202,052&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;202,527&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;168,369&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Assumed liabilities through
 acquisition&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;20,716&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;35,968&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Provision (adjustment) for
 losses related to:&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Current year&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;41,291&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;38,129&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;39,204&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Prior years&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;9,983&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(25,428&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(25,797&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Total provision for
 losses&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;51,274&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;12,701&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;13,407&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Claim payments related
 to:&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Current year&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(712&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(766&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(1,382&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Prior years&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(23,143&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(12,410&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(13,835&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Total payments&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(23,855&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(13,176&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;(15,217&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;)&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 1px solid"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;Balance at end of
 year&lt;/font&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;250,187&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;202,052&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font size="1"&gt;&amp;#xA0;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;$&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;202,527&lt;/font&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;font style="FONT-FAMILY: Times New Roman" size="2"&gt;&amp;#xA0;&lt;/font&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="BORDER-TOP: #000000 3px double"&gt;&amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;/div&gt;</md:ScheduleOfAccruedProfessionalLiabilityTableTextBlock>
  <md:NumberOfPediatricMultiSpecialtyPracticesAcquired contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="Company" decimals="INF" id="id_12960622_C795A629-E311-4179-965D-2E2D3C59C2DD_1_4">1</md:NumberOfPediatricMultiSpecialtyPracticesAcquired>
  <md:EffectiveIncomeTaxRateContinuingOperationsExcludingChangeInTaxRate contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="pure" decimals="4" id="id_12960622_12F6ADC7-EFAD-4C29-A4B6-F8D0060BC7A6_1_2">0.3900</md:EffectiveIncomeTaxRateContinuingOperationsExcludingChangeInTaxRate>
  <md:IncomeTaxExpenseForExcessTaxDeficiencies contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_12960622_7C68CBCA-4D12-4EF7-A12E-956E93D1FB9B_1_1">200000</md:IncomeTaxExpenseForExcessTaxDeficiencies>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1 contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2433414x2438181" id="id_12960622_858FD8C3-6FB9-4AE9-A234-F2062FE90B40_1002_1">P3Y</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1>
  <us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2433414x2438181_2447194x2442860" id="id_12960622_858FD8C3-6FB9-4AE9-A234-F2062FE90B40_2002_3">P10Y</us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod>
  <us-gaap:AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2433414x2447533" unitRef="iso4217_USD" decimals="-5" id="id_12960622_692ACA19-C775-49B6-B63F-40464D11144C_1001_3">2100000</us-gaap:AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation>
  <us-gaap:SharesPaidForTaxWithholdingForShareBasedCompensation contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2433414x2447533" unitRef="shares" decimals="0" id="id_12960622_692ACA19-C775-49B6-B63F-40464D11144C_1001_2">38257</us-gaap:SharesPaidForTaxWithholdingForShareBasedCompensation>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1 contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2433414x2447533" id="id_12960622_858FD8C3-6FB9-4AE9-A234-F2062FE90B40_3002_4">P3Y</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1>
  <us-gaap:EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1 contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2433414x2738709" id="id_12960622_5EC7EBDF-7216-4532-A802-0959ED354644_1001_0">P1Y7M6D</us-gaap:EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1>
  <us-gaap:GoodwillPurchaseAccountingAdjustments contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2433694x2686524" unitRef="iso4217_USD" decimals="-5" id="id_12960622_3E4C5B50-328B-4E8F-A81A-90AFB2B12F1F_1001_1">500000</us-gaap:GoodwillPurchaseAccountingAdjustments>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2434587x2432958_2434588x2439812" unitRef="pure" decimals="2" id="id_12960622_FD502645-1100-4961-ACBB-4996D4EF2111_1001_0">0.17</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2434587x2447785_2434588x2446251" unitRef="pure" decimals="INF" id="id_12960622_5DEAC78F-20F1-4F01-8FE7-3E19D142F1D3_1001_6">1.00</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2434587x2447785_2434588x2446251_2446084x2668897" unitRef="pure" decimals="2" id="id_12960622_5DEAC78F-20F1-4F01-8FE7-3E19D142F1D3_2001_5">0.03</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2434587x2447785_2434588x2446251_2446084x2680097" unitRef="pure" decimals="2" id="id_12960622_5DEAC78F-20F1-4F01-8FE7-3E19D142F1D3_3001_4">0.06</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2434587x2447785_2434588x2446251_2446084x2695079" unitRef="pure" decimals="2" id="id_12960622_5DEAC78F-20F1-4F01-8FE7-3E19D142F1D3_4001_1">0.37</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2434587x2447785_2434588x2446251_2446084x2695080" unitRef="pure" decimals="2" id="id_12960622_5DEAC78F-20F1-4F01-8FE7-3E19D142F1D3_5001_0">0.38</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2434587x2447785_2434588x2446251_2446084x2695081" unitRef="pure" decimals="2" id="id_12960622_5DEAC78F-20F1-4F01-8FE7-3E19D142F1D3_6001_2">0.08</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2434587x2447785_2434588x2446251_2446084x3031709" unitRef="pure" decimals="2" id="id_12960622_5DEAC78F-20F1-4F01-8FE7-3E19D142F1D3_7001_3">0.08</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:FairValueInputsDiscountRate contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2435314x2658296_2447194x2442860" unitRef="pure" decimals="INF" id="id_12960622_F5250E6F-0D73-4C12-BA4A-24C072723442_1003_2">0.0475</us-gaap:FairValueInputsDiscountRate>
  <us-gaap:FairValueInputsDiscountRate contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2435314x2658296_2447194x2443301" unitRef="pure" decimals="INF" id="id_12960622_F5250E6F-0D73-4C12-BA4A-24C072723442_1002_2">0.0400</us-gaap:FairValueInputsDiscountRate>
  <us-gaap:DebtInstrumentMaturityDateDescription contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2435419x2705617" id="id_12960622_34AE1FCE-0717-4D07-A147-F522C1947F87_1002_2">Payable semi-annually in arrears on June 1 and December 1</us-gaap:DebtInstrumentMaturityDateDescription>
  <md:DebtInstrumentMaturityYear contextRef="eol_PE10840---1710-K0011_STD_365_20171231_0_2435419x2705617" id="id_12960622_C1FC69B8-08BC-4577-933C-EDC79368F00D_1001_1">2023</md:DebtInstrumentMaturityYear>
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        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:linkbaseRef xlink:type="simple" xlink:arcrole="http://www.w3.org/1999/xlink/properties/linkbase" xlink:role="http://www.xbrl.org/2003/role/calculationLinkbaseRef" xlink:href="md-20171231_cal.xml" xlink:title="Calculation Links, all"/>
      <link:linkbaseRef xlink:type="simple" xlink:arcrole="http://www.w3.org/1999/xlink/properties/linkbase" xlink:role="http://www.xbrl.org/2003/role/definitionLinkbaseRef" xlink:href="md-20171231_def.xml" xlink:title="Definition Links, all"/>
      <link:linkbaseRef xlink:type="simple" xlink:arcrole="http://www.w3.org/1999/xlink/properties/linkbase" xlink:role="http://www.xbrl.org/2003/role/labelLinkbaseRef" xlink:href="md-20171231_lab.xml" xlink:title="Label Links, all"/>
      <link:linkbaseRef xlink:type="simple" xlink:arcrole="http://www.w3.org/1999/xlink/properties/linkbase" xlink:role="http://www.xbrl.org/2003/role/presentationLinkbaseRef" xlink:href="md-20171231_pre.xml" xlink:title="Presentation Links, all"/>
    </appinfo>
  </annotation>
  <import namespace="http://www.xbrl.org/2003/instance" schemaLocation="http://www.xbrl.org/2003/xbrl-instance-2003-12-31.xsd"/>
  <import namespace="http://www.xbrl.org/2003/linkbase" schemaLocation="http://www.xbrl.org/2003/xbrl-linkbase-2003-12-31.xsd"/>
  <import namespace="http://fasb.org/us-types/2017-01-31" schemaLocation="http://xbrl.fasb.org/us-gaap/2017/elts/us-types-2017-01-31.xsd"/>
  <import namespace="http://www.xbrl.org/dtr/type/non-numeric" schemaLocation="http://www.xbrl.org/dtr/type/nonNumeric-2009-12-16.xsd"/>
  <import namespace="http://www.xbrl.org/dtr/type/numeric" schemaLocation="http://www.xbrl.org/dtr/type/numeric-2009-12-16.xsd"/>
  <import namespace="http://xbrl.org/2005/xbrldt" schemaLocation="http://www.xbrl.org/2005/xbrldt-2005.xsd"/>
  <import namespace="http://fasb.org/us-gaap/2017-01-31" schemaLocation="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/country/2017-01-31" schemaLocation="http://xbrl.sec.gov/country/2017/country-2017-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/currency/2017-01-31" schemaLocation="http://xbrl.sec.gov/currency/2017/currency-2017-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/dei/2014-01-31" schemaLocation="http://xbrl.sec.gov/dei/2014/dei-2014-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/exch/2017-01-31" schemaLocation="http://xbrl.sec.gov/exch/2017/exch-2017-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/invest/2013-01-31" schemaLocation="http://xbrl.sec.gov/invest/2013/invest-2013-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/naics/2017-01-31" schemaLocation="http://xbrl.sec.gov/naics/2017/naics-2017-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/sic/2011-01-31" schemaLocation="http://xbrl.sec.gov/sic/2011/sic-2011-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/stpr/2011-01-31" schemaLocation="http://xbrl.sec.gov/stpr/2011/stpr-2011-01-31.xsd"/>
  <element name="AcceleratedShareRepurchaseAgreementsMember" id="md_AcceleratedShareRepurchaseAgreementsMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent" id="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AccruedContingentConsiderationLiabilityCurrent" id="md_AccruedContingentConsiderationLiabilityCurrent" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AccruedPayrollTaxesAndBenefitsCurrent" id="md_AccruedPayrollTaxesAndBenefitsCurrent" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AccruedProfessionalLiabilitiesAssumedThroughAcquisition" id="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AccruedProfessionalLiability" id="md_AccruedProfessionalLiability" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AlternateBaseRateMember" id="md_AlternateBaseRateMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AmendedAndRestatedTwoThousandEightPlanMember" id="md_AmendedAndRestatedTwoThousandEightPlanMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AnesthesiologyMember" id="md_AnesthesiologyMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ApplicableMarginRateMember" id="md_ApplicableMarginRateMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="BusinessCombinationContingentConsiderationArrangementsTimePeriod" id="md_BusinessCombinationContingentConsiderationArrangementsTimePeriod" type="xbrli:durationItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="BusinessCombinationDispositionOrAssignmentRestrictionPeriod" id="md_BusinessCombinationDispositionOrAssignmentRestrictionPeriod" type="xbrli:durationItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="CashAndCashEquivalentsMaturityDescription" id="md_CashAndCashEquivalentsMaturityDescription" type="xbrli:stringItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ChangeInControlMember" id="md_ChangeInControlMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="CommonStockLineItems" id="md_CommonStockLineItems" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="CommonStockRepurchasesTextBlock" id="md_CommonStockRepurchasesTextBlock" type="nonnum:textBlockItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="CommonStockShareRepurchasesPolicyTextBlock" id="md_CommonStockShareRepurchasesPolicyTextBlock" type="nonnum:textBlockItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="CommonStockTable" id="md_CommonStockTable" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrldt:hypercubeItem"/>
  <element name="ContingentConsiderationMember" id="md_ContingentConsiderationMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ContractualAdjustmentsAndUncollectibles" id="md_ContractualAdjustmentsAndUncollectibles" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="DebtInstrumentCarryingAmountCurrent" id="md_DebtInstrumentCarryingAmountCurrent" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="DebtInstrumentCarryingAmountNonCurrent" id="md_DebtInstrumentCarryingAmountNonCurrent" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="DebtInstrumentMaturityYear" id="md_DebtInstrumentMaturityYear" type="xbrli:gYearItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="DebtInstrumentRedemptionPeriodBeforeTwoThousandEighteenMember" id="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandEighteenMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="DebtInstrumentRedemptionPeriodFourAndThereafterMember" id="md_DebtInstrumentRedemptionPeriodFourAndThereafterMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="DeconsolidationPercentage" id="md_DeconsolidationPercentage" type="num:percentItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="DocumentAndEntityInformationAbstract" id="md_DocumentAndEntityInformationAbstract" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="EffectiveIncomeTaxRateContinuingOperationsExcludingChangeInTaxRate" id="md_EffectiveIncomeTaxRateContinuingOperationsExcludingChangeInTaxRate" type="num:percentItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="EffectiveIncomeTaxRateContinuingOperationsExcludingImpactOfTaxSettlement" id="md_EffectiveIncomeTaxRateContinuingOperationsExcludingImpactOfTaxSettlement" type="num:percentItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" id="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="GoodwillAndOtherIntangibleAssetsLineItems" id="md_GoodwillAndOtherIntangibleAssetsLineItems" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="GoodwillAndOtherIntangibleAssetsTable" id="md_GoodwillAndOtherIntangibleAssetsTable" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrldt:hypercubeItem"/>
  <element name="HealthOrganizationRevenueGross" id="md_HealthOrganizationRevenueGross" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="HospitalContractAdministrativeFees" id="md_HospitalContractAdministrativeFees" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="IncomeTaxExpenseForExcessTaxDeficiencies" id="md_IncomeTaxExpenseForExcessTaxDeficiencies" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="IncomeTaxLineItems" id="md_IncomeTaxLineItems" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="IncomeTaxTable" id="md_IncomeTaxTable" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrldt:hypercubeItem"/>
  <element name="InterestAndPenaltiesMember" id="md_InterestAndPenaltiesMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit" id="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="LongTermInvestmentsMaturityPeriod" id="md_LongTermInvestmentsMaturityPeriod" type="xbrli:durationItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="MalpracticeLossContingencyProvisionForLosses" id="md_MalpracticeLossContingencyProvisionForLosses" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ManagementServicesMember" id="md_ManagementServicesMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="MaternalFetalMedicineMember" id="md_MaternalFetalMedicineMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember" id="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="MoneyMarketFundsAtFairValue" id="md_MoneyMarketFundsAtFairValue" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NeonatologyAndOtherPediatricSubspecialtiesMember" id="md_NeonatologyAndOtherPediatricSubspecialtiesMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NetOperatingLossCarryForwardsExpirationDate" id="md_NetOperatingLossCarryForwardsExpirationDate" type="xbrli:gYearItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember" id="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember" id="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfAnesthesiologyPracticesAcquired" id="md_NumberOfAnesthesiologyPracticesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfMaternalfetalMedicinePracticesAcquired" id="md_NumberOfMaternalfetalMedicinePracticesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfNeonatologyPracticesAcquired" id="md_NumberOfNeonatologyPracticesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfPatientEngagementSoftwareCompanyAcquired" id="md_NumberOfPatientEngagementSoftwareCompanyAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfPediatricCardiologyPracticesAcquired" id="md_NumberOfPediatricCardiologyPracticesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfPediatricMultiSpecialtyPracticesAcquired" id="md_NumberOfPediatricMultiSpecialtyPracticesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfPediatricSubspecialtyPracticesAcquired" id="md_NumberOfPediatricSubspecialtyPracticesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfPhysicianGroupPracticesAcquired" id="md_NumberOfPhysicianGroupPracticesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfRadiologyPracticesAcquired" id="md_NumberOfRadiologyPracticesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfThirdpartyReceivablesCompaniesAcquired" id="md_NumberOfThirdpartyReceivablesCompaniesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PatentedAndOtherTechnologyMember" id="md_PatentedAndOtherTechnologyMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PediatricCardiologyMember" id="md_PediatricCardiologyMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PhysicianAndHospitalAgreementsMember" id="md_PhysicianAndHospitalAgreementsMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PhysicianGroupMember" id="md_PhysicianGroupMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PracticeSalariesAndBenefits" id="md_PracticeSalariesAndBenefits" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PracticeSuppliesAndOtherOperatingExpenses" id="md_PracticeSuppliesAndOtherOperatingExpenses" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PriorPeriodAcquisitionsMember" id="md_PriorPeriodAcquisitionsMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ProfessionalLiabilityCoveragePolicyTextBlock" id="md_ProfessionalLiabilityCoveragePolicyTextBlock" type="nonnum:textBlockItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract" id="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ProvisionAdjustmentForLossesRelatedToCurrentYear" id="md_ProvisionAdjustmentForLossesRelatedToCurrentYear" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ProvisionAdjustmentForLossesRelatedToPriorYear" id="md_ProvisionAdjustmentForLossesRelatedToPriorYear" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PurchaseConsiderationLiability" id="md_PurchaseConsiderationLiability" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="RadiologyAndTeleradiologyMember" id="md_RadiologyAndTeleradiologyMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="RecentlyAdoptedAccountingPronouncementsPolicyTextBlock" id="md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock" type="nonnum:textBlockItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember" id="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="RegulatoryAssetsAbstract" id="md_RegulatoryAssetsAbstract" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="RestrictedAndDeferredStockUnitsMember" id="md_RestrictedAndDeferredStockUnitsMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="SaleOfMinorityInterestPercentage" id="md_SaleOfMinorityInterestPercentage" type="num:percentItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ScheduleOfAccruedProfessionalLiabilityTableTextBlock" id="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock" type="nonnum:textBlockItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ScheduleOfCapitalLeaseObligationsTableTextBlock" id="md_ScheduleOfCapitalLeaseObligationsTableTextBlock" type="nonnum:textBlockItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ShortTermInvestmentMaturityPeriod" id="md_ShortTermInvestmentMaturityPeriod" type="xbrli:durationItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration" id="md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration" type="xbrli:sharesItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="StockIssuedDuringPeriodSharesRestrictedStockAndVestingOfDeferredStock" id="md_StockIssuedDuringPeriodSharesRestrictedStockAndVestingOfDeferredStock" type="xbrli:sharesItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration" id="md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="StockIssuedDuringPeriodValueRestrictedStockAndVestingOfDeferredStock" id="md_StockIssuedDuringPeriodValueRestrictedStockAndVestingOfDeferredStock" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="SummaryOfSignificantAccountingPoliciesLineItems" id="md_SummaryOfSignificantAccountingPoliciesLineItems" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="SummaryOfSignificantAccountingPoliciesTable" id="md_SummaryOfSignificantAccountingPoliciesTable" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrldt:hypercubeItem"/>
  <element name="TermLoanCreditFacilityMember" id="md_TermLoanCreditFacilityMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="TwoThousandFifteenNonQualifiedStockPurchasePlanMember" id="md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="UnamortizedDebtIssuanceExpenseCurrent" id="md_UnamortizedDebtIssuanceExpenseCurrent" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="UnamortizedDebtIssuanceExpenseNoncurrent" id="md_UnamortizedDebtIssuanceExpenseNoncurrent" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="UnnamedCorporateJointVentureMember" id="md_UnnamedCorporateJointVentureMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="UnrecognizedTaxBenefitsImpactEffectiveTaxRate" id="md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="UnsecuredRevolvingCreditFacilityMember" id="md_UnsecuredRevolvingCreditFacilityMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
</schema>
</XBRL>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-101.CAL
<SEQUENCE>14
<FILENAME>md-20171231_cal.xml
<DESCRIPTION>XBRL TAXONOMY EXTENSION CALCULATION LINKBASE
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<XBRL>
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<!-- Version: 6.23.6 -->
<!-- Round: 5 -->
<!-- Creation date: 2018-02-14T15:44:06Z -->
<!-- Copyright (c) 2017 Donnelley Financial, LLC. All Rights Reserved. -->
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  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlockTables">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsScheduleOfValuationAndQualifyingAccountsDisclosureTextBlock">
  </calculationLink>
</linkbase>
</XBRL>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-101.DEF
<SEQUENCE>15
<FILENAME>md-20171231_def.xml
<DESCRIPTION>XBRL TAXONOMY EXTENSION DEFINITION LINKBASE
<TEXT>
<XBRL>
<?xml version="1.0" encoding="US-ASCII"?>
<!-- DFS Xcelerate Taxonomy Definition Linkbase - http://www.dfsco.com/financial-services/ -->
<!-- Version: 6.23.6 -->
<!-- Round: 5 -->
<!-- Creation date: 2018-02-14T15:44:06Z -->
<!-- Copyright (c) 2017 Donnelley Financial, LLC. All Rights Reserved. -->
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    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_CommonStockLineItems" xlink:to="us-gaap_StockRepurchasedDuringPeriodShares" order="1.0100" priority="2" use="optional"/>
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    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareRepurchaseProgramDomain" xlink:to="md_AcceleratedShareRepurchaseAgreementsMember" order="1.0900" priority="2" use="optional"/>
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</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-101.LAB
<SEQUENCE>16
<FILENAME>md-20171231_lab.xml
<DESCRIPTION>XBRL TAXONOMY EXTENSION LABEL LINKBASE
<TEXT>
<XBRL>
<?xml version="1.0" encoding="US-ASCII"?>
<!-- DFS Xcelerate Taxonomy Labels Linkbase - http://www.dfsco.com/financial-services/ -->
<!-- Version: 6.23.6 -->
<!-- Round: 5 -->
<!-- Creation date: 2018-02-14T15:44:06Z -->
<!-- Copyright (c) 2017 Donnelley Financial, LLC. All Rights Reserved. -->
<linkbase xmlns="http://www.xbrl.org/2003/linkbase"
  xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
  xmlns:xlink="http://www.w3.org/1999/xlink"
  xsi:schemaLocation="http://www.xbrl.org/2003/linkbase http://www.xbrl.org/2003/xbrl-linkbase-2003-12-31.xsd">
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  <roleRef xlink:type="simple" xlink:href="http://www.xbrl.org/lrr/role/negated-2009-12-16.xsd#negatedTotalLabel" roleURI="http://www.xbrl.org/2009/role/negatedTotalLabel"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AcceleratedShareRepurchaseAgreementsMember_lbl" xml:lang="en-US" id="id_12960622_2721388_1_1">Accelerated Share Repurchase Agreements [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AcceleratedShareRepurchaseAgreementsMember_lbl" xml:lang="en-US" id="id_12960622_2721388_2_1">Accelerated Share Repurchase (ASR) Agreements [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AcceleratedShareRepurchaseAgreementsMember" xlink:to="md_AcceleratedShareRepurchaseAgreementsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt" xlink:label="us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt_lbl" xml:lang="en-US" id="id_12960622_2432716_2_1">Common stock purchase</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt" xlink:to="us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:label="us-gaap_AccountingPoliciesAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccountingPoliciesAbstract_lbl" xml:lang="en-US" id="id_12960622_2432506_1_1">Accounting Policies [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccountingPoliciesAbstract_lbl" xml:lang="en-US" id="id_12960622_2432506_2_1">Accounting Policies [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_AccountingPoliciesAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent_lbl" xml:lang="en-US" id="id_12960622_2432948_1_1">Accounts Payable and Accrued Liabilities, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent_lbl" xml:lang="en-US" id="id_12960622_2432948_6_1">Accounts payable and accrued expenses, total</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent" xlink:to="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2432527_1_1">Accounts Payable and Accrued Liabilities Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2432527_2_1">Accounts Payable and Accrued Expenses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock" xlink:to="us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent" xlink:label="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent_lbl" xml:lang="en-US" id="id_12960622_2554823_3_1">Accounts payable and accrued liabilities excluding accrued income taxes current.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent_lbl" xml:lang="en-US" id="id_12960622_2554823_1_1">Accounts Payable and Accrued Liabilities Excluding Accrued Income Taxes Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent_lbl" xml:lang="en-US" id="id_12960622_2554823_2_1">Accounts payable and accrued expenses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent" xlink:to="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AccountsPayableCurrent" xlink:label="us-gaap_AccountsPayableCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccountsPayableCurrent_lbl" xml:lang="en-US" id="id_12960622_2432952_1_1">Accounts Payable, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccountsPayableCurrent_lbl" xml:lang="en-US" id="id_12960622_2432952_2_1">Accounts payable</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccountsPayableCurrent" xlink:to="us-gaap_AccountsPayableCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AccountsReceivableGrossCurrent" xlink:label="us-gaap_AccountsReceivableGrossCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccountsReceivableGrossCurrent_lbl" xml:lang="en-US" id="id_12960622_2432957_1_1">Accounts Receivable, Gross, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccountsReceivableGrossCurrent_lbl" xml:lang="en-US" id="id_12960622_2432957_2_1">Gross accounts receivable</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccountsReceivableGrossCurrent" xlink:to="us-gaap_AccountsReceivableGrossCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AccountsReceivableMember" xlink:label="us-gaap_AccountsReceivableMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccountsReceivableMember_lbl" xml:lang="en-US" id="id_12960622_2432958_1_1">Accounts Receivable [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccountsReceivableMember_lbl" xml:lang="en-US" id="id_12960622_2432958_2_1">Accounts Receivable [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccountsReceivableMember" xlink:to="us-gaap_AccountsReceivableMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AccountsReceivableNetCurrent" xlink:label="us-gaap_AccountsReceivableNetCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccountsReceivableNetCurrent_lbl" xml:lang="en-US" id="id_12960622_2432742_1_1">Accounts Receivable, Net, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccountsReceivableNetCurrent_lbl" xml:lang="en-US" id="id_12960622_2432742_2_1">Accounts receivable, net</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_AccountsReceivableNetCurrent_lbl" xml:lang="en-US" id="id_12960622_2432742_6_1">Accounts receivable, net</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccountsReceivableNetCurrent" xlink:to="us-gaap_AccountsReceivableNetCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_AccruedContingentConsiderationLiabilityCurrent" xlink:label="md_AccruedContingentConsiderationLiabilityCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AccruedContingentConsiderationLiabilityCurrent_lbl" xml:lang="en-US" id="id_12960622_2601001_3_1">Accrued contingent consideration liability current.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AccruedContingentConsiderationLiabilityCurrent_lbl" xml:lang="en-US" id="id_12960622_2601001_1_1">Accrued Contingent Consideration Liability Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AccruedContingentConsiderationLiabilityCurrent_lbl" xml:lang="en-US" id="id_12960622_2601001_2_1">Accrued contingent consideration</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AccruedContingentConsiderationLiabilityCurrent" xlink:to="md_AccruedContingentConsiderationLiabilityCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AccruedIncomeTaxesCurrent" xlink:label="us-gaap_AccruedIncomeTaxesCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccruedIncomeTaxesCurrent_lbl" xml:lang="en-US" id="id_12960622_2432325_1_1">Accrued Income Taxes, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccruedIncomeTaxesCurrent_lbl" xml:lang="en-US" id="id_12960622_2432325_2_1">Income taxes payable</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccruedIncomeTaxesCurrent" xlink:to="us-gaap_AccruedIncomeTaxesCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_AccruedPayrollTaxesAndBenefitsCurrent" xlink:label="md_AccruedPayrollTaxesAndBenefitsCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AccruedPayrollTaxesAndBenefitsCurrent_lbl" xml:lang="en-US" id="id_12960622_2597652_3_1">Accrued payroll taxes and benefits current.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AccruedPayrollTaxesAndBenefitsCurrent_lbl" xml:lang="en-US" id="id_12960622_2597652_1_1">Accrued Payroll Taxes And Benefits Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AccruedPayrollTaxesAndBenefitsCurrent_lbl" xml:lang="en-US" id="id_12960622_2597652_2_1">Accrued payroll taxes and benefits</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AccruedPayrollTaxesAndBenefitsCurrent" xlink:to="md_AccruedPayrollTaxesAndBenefitsCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition" xlink:label="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition_lbl" xml:lang="en-US" id="id_12960622_2596991_3_1">Accrued professional liabilities assumed through acquisition.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition_lbl" xml:lang="en-US" id="id_12960622_2596991_1_1">Accrued Professional Liabilities Assumed Through Acquisition</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition_lbl" xml:lang="en-US" id="id_12960622_2596991_2_1">Assumed liabilities through acquisition</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition" xlink:to="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_AccruedProfessionalLiability" xlink:label="md_AccruedProfessionalLiability"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AccruedProfessionalLiability_lbl" xml:lang="en-US" id="id_12960622_2582175_3_1">Accrued professional liability.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AccruedProfessionalLiability_lbl" xml:lang="en-US" id="id_12960622_2582175_1_1">Accrued Professional Liability</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AccruedProfessionalLiability_lbl" xml:lang="en-US" id="id_12960622_2582175_2_1">Accrued professional liability incurred and loss reserves reported for claims</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AccruedProfessionalLiability" xlink:to="md_AccruedProfessionalLiability_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AccruedSalariesCurrent" xlink:label="us-gaap_AccruedSalariesCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccruedSalariesCurrent_lbl" xml:lang="en-US" id="id_12960622_2432987_1_1">Accrued Salaries, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccruedSalariesCurrent_lbl" xml:lang="en-US" id="id_12960622_2432987_2_1">Accrued salaries and bonuses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccruedSalariesCurrent" xlink:to="us-gaap_AccruedSalariesCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" xlink:label="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment_lbl" xml:lang="en-US" id="id_12960622_2432772_1_1">Accumulated Depreciation, Depletion and Amortization, Property, Plant, and Equipment</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment_lbl" xml:lang="en-US" id="id_12960622_2432772_2_1">Accumulated depreciation of property and equipment held under capital leases</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment_lbl" xml:lang="en-US" id="id_12960622_2432772_14_1">Accumulated depreciation</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" xlink:to="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" xlink:label="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife_lbl" xml:lang="en-US" id="id_12960622_2432778_1_1">Acquired Finite-lived Intangible Assets, Weighted Average Useful Life</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife_lbl" xml:lang="en-US" id="id_12960622_2432778_2_1">Weighted average amortization period</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" xlink:to="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AdditionalPaidInCapitalCommonStock" xlink:label="us-gaap_AdditionalPaidInCapitalCommonStock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AdditionalPaidInCapitalCommonStock_lbl" xml:lang="en-US" id="id_12960622_2432790_1_1">Additional Paid in Capital, Common Stock</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AdditionalPaidInCapitalCommonStock_lbl" xml:lang="en-US" id="id_12960622_2432790_2_1">Additional paid-in capital</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AdditionalPaidInCapitalCommonStock" xlink:to="us-gaap_AdditionalPaidInCapitalCommonStock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AdditionalPaidInCapitalMember" xlink:label="us-gaap_AdditionalPaidInCapitalMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AdditionalPaidInCapitalMember_lbl" xml:lang="en-US" id="id_12960622_2432358_1_1">Additional Paid-in Capital [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AdditionalPaidInCapitalMember_lbl" xml:lang="en-US" id="id_12960622_2432358_2_1">Additional Paid-in Capital [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AdditionalPaidInCapitalMember" xlink:to="us-gaap_AdditionalPaidInCapitalMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation" xlink:label="us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation_lbl" xml:lang="en-US" id="id_12960622_2432366_1_1">Adjustments Related to Tax Withholding for Share-based Compensation</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation_lbl" xml:lang="en-US" id="id_12960622_2432366_2_1">Amount withheld to satisfy minimum statutory tax withholding obligations</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation" xlink:to="us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue_lbl" xml:lang="en-US" id="id_12960622_2432802_1_1">Adjustments to Additional Paid in Capital, Share-based Compensation, Requisite Service Period Recognition</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue_lbl" xml:lang="en-US" id="id_12960622_2432802_2_1">Stock-based compensation expense</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue" xlink:to="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation_lbl" xml:lang="en-US" id="id_12960622_2432600_1_1">Adjustments to Additional Paid in Capital, Income Tax Benefit from Share-based Compensation</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation_lbl" xml:lang="en-US" id="id_12960622_2432600_2_1">Excess tax benefit related to employee stock incentive plans</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation" xlink:to="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:label="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract_lbl" xml:lang="en-US" id="id_12960622_2433031_1_1">Adjustments to Reconcile Net Income (Loss) to Cash Provided by (Used in) Operating Activities [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract_lbl" xml:lang="en-US" id="id_12960622_2433031_2_1">Adjustments to reconcile net income to net cash provided from operating activities:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet" xlink:label="us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet_lbl" xml:lang="en-US" id="id_12960622_2433032_1_1">Adjustment to Additional Paid in Capital, Income Tax Effect from Share-based Compensation, Net</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet_lbl" xml:lang="en-US" id="id_12960622_2433032_2_1">Adjustment to additional paid-in capital for excess tax benefits related to stock-based awards</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet" xlink:to="us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AllocatedShareBasedCompensationExpense" xlink:label="us-gaap_AllocatedShareBasedCompensationExpense"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AllocatedShareBasedCompensationExpense_lbl" xml:lang="en-US" id="id_12960622_2432632_1_1">Allocated Share-based Compensation Expense</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AllocatedShareBasedCompensationExpense_lbl" xml:lang="en-US" id="id_12960622_2432632_2_1">Stock-based compensation expense related to its stock incentive plans, ESPP and SPP</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AllocatedShareBasedCompensationExpense" xlink:to="us-gaap_AllocatedShareBasedCompensationExpense_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent" xlink:label="us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent_lbl" xml:lang="en-US" id="id_12960622_2432404_1_1">Allowance for Doubtful Accounts Receivable, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent_lbl" xml:lang="en-US" id="id_12960622_2432404_14_1">Allowance for contractual adjustments and uncollectibles</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent" xlink:to="us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_AlternateBaseRateMember" xlink:label="md_AlternateBaseRateMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AlternateBaseRateMember_lbl" xml:lang="en-US" id="id_12960622_2732973_3_1">Alternate base rate.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AlternateBaseRateMember_lbl" xml:lang="en-US" id="id_12960622_2732973_1_1">Alternate Base Rate [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AlternateBaseRateMember_lbl" xml:lang="en-US" id="id_12960622_2732973_2_1">Alternate Base Rate [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AlternateBaseRateMember" xlink:to="md_AlternateBaseRateMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_AmendedAndRestatedTwoThousandEightPlanMember" xlink:label="md_AmendedAndRestatedTwoThousandEightPlanMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AmendedAndRestatedTwoThousandEightPlanMember_lbl" xml:lang="en-US" id="id_12960622_2700637_3_1">Amended and restated two thousand eight plan.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AmendedAndRestatedTwoThousandEightPlanMember_lbl" xml:lang="en-US" id="id_12960622_2700637_1_1">Amended and Restated Two Thousand Eight Plan [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AmendedAndRestatedTwoThousandEightPlanMember_lbl" xml:lang="en-US" id="id_12960622_2700637_2_1">Amended and Restated 2008 Plan [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AmendedAndRestatedTwoThousandEightPlanMember" xlink:to="md_AmendedAndRestatedTwoThousandEightPlanMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.sec.gov/dei/2014/dei-2014-01-31.xsd#dei_AmendmentFlag" xlink:label="dei_AmendmentFlag"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_AmendmentFlag_lbl" xml:lang="en-US" id="id_12960622_2432431_1_1">Amendment Flag</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_AmendmentFlag_lbl" xml:lang="en-US" id="id_12960622_2432431_2_1">Amendment Flag</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AmortizationOfFinancingCostsAndDiscounts" xlink:label="us-gaap_AmortizationOfFinancingCostsAndDiscounts"/>
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    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_AnesthesiologyMember" xlink:label="md_AnesthesiologyMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AnesthesiologyMember_lbl" xml:lang="en-US" id="id_12960622_2695080_3_1">Anesthesiology.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AnesthesiologyMember_lbl" xml:lang="en-US" id="id_12960622_2695080_1_1">Anesthesiology [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AnesthesiologyMember_lbl" xml:lang="en-US" id="id_12960622_2695080_2_1">Anesthesiology [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AnesthesiologyMember" xlink:to="md_AnesthesiologyMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount" xlink:label="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount_lbl" xml:lang="en-US" id="id_12960622_2432677_1_1">Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount</label>
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    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_ApplicableMarginRateMember" xlink:label="md_ApplicableMarginRateMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ApplicableMarginRateMember_lbl" xml:lang="en-US" id="id_12960622_2674553_3_1">Applicable margin rate.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ApplicableMarginRateMember_lbl" xml:lang="en-US" id="id_12960622_2674553_1_1">Applicable Margin Rate [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ApplicableMarginRateMember_lbl" xml:lang="en-US" id="id_12960622_2674553_2_1">Applicable Margin Rate [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ApplicableMarginRateMember" xlink:to="md_ApplicableMarginRateMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_Assets" xlink:label="us-gaap_Assets"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_Assets_lbl" xml:lang="en-US" id="id_12960622_2433119_1_1">Assets</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_Assets_lbl" xml:lang="en-US" id="id_12960622_2433119_6_1">Total assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_Assets" xlink:to="us-gaap_Assets_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AssetsAbstract" xlink:label="us-gaap_AssetsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AssetsAbstract_lbl" xml:lang="en-US" id="id_12960622_2432695_1_1">Assets [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AssetsAbstract_lbl" xml:lang="en-US" id="id_12960622_2432695_2_1">ASSETS</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_AssetsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AssetsCurrent" xlink:label="us-gaap_AssetsCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AssetsCurrent_lbl" xml:lang="en-US" id="id_12960622_2432697_1_1">Assets, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_AssetsCurrent_lbl" xml:lang="en-US" id="id_12960622_2432697_6_1">Total current assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AssetsCurrent" xlink:to="us-gaap_AssetsCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AssetsCurrentAbstract" xlink:label="us-gaap_AssetsCurrentAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AssetsCurrentAbstract_lbl" xml:lang="en-US" id="id_12960622_2433122_1_1">Assets, Current [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AssetsCurrentAbstract_lbl" xml:lang="en-US" id="id_12960622_2433122_2_1">Current assets:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AssetsCurrentAbstract" xlink:to="us-gaap_AssetsCurrentAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrent" xlink:label="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrent_lbl" xml:lang="en-US" id="id_12960622_2432480_1_1">Assets Held-for-sale, Not Part of Disposal Group, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrent_lbl" xml:lang="en-US" id="id_12960622_2432480_2_1">Assets held for sale, current</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrent" xlink:to="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrentOther" xlink:label="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrentOther"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrentOther_lbl" xml:lang="en-US" id="id_12960622_2432481_1_1">Assets Held-for-sale, Not Part of Disposal Group, Current, Other</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrentOther_lbl" xml:lang="en-US" id="id_12960622_2432481_2_1">Assets held for sale, other noncurrent assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrentOther" xlink:to="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrentOther_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_AwardTypeAxis" xlink:label="us-gaap_AwardTypeAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AwardTypeAxis_lbl" xml:lang="en-US" id="id_12960622_2433414_1_1">Award Type [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AwardTypeAxis_lbl" xml:lang="en-US" id="id_12960622_2433414_2_1">Award Type [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_AwardTypeAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_BuildingMember" xlink:label="us-gaap_BuildingMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BuildingMember_lbl" xml:lang="en-US" id="id_12960622_2433474_1_1">Building [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BuildingMember_lbl" xml:lang="en-US" id="id_12960622_2433474_2_1">Buildings [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BuildingMember" xlink:to="us-gaap_BuildingMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_BuildingsAndImprovementsGross" xlink:label="us-gaap_BuildingsAndImprovementsGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BuildingsAndImprovementsGross_lbl" xml:lang="en-US" id="id_12960622_2433253_1_1">Buildings and Improvements, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BuildingsAndImprovementsGross_lbl" xml:lang="en-US" id="id_12960622_2433253_2_1">Building</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BuildingsAndImprovementsGross" xlink:to="us-gaap_BuildingsAndImprovementsGross_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_BusinessAcquisitionAcquireeDomain" xlink:label="us-gaap_BusinessAcquisitionAcquireeDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessAcquisitionAcquireeDomain_lbl" xml:lang="en-US" id="id_12960622_2433916_1_1">Business Acquisition, Acquiree [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessAcquisitionAcquireeDomain_lbl" xml:lang="en-US" id="id_12960622_2433916_2_1">Business Acquisition, Acquiree [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessAcquisitionAcquireeDomain" xlink:to="us-gaap_BusinessAcquisitionAcquireeDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_BusinessAcquisitionAxis" xlink:label="us-gaap_BusinessAcquisitionAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessAcquisitionAxis_lbl" xml:lang="en-US" id="id_12960622_2433694_1_1">Business Acquisition [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessAcquisitionAxis_lbl" xml:lang="en-US" id="id_12960622_2433694_2_1">Business Acquisition [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="us-gaap_BusinessAcquisitionAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_BusinessAcquisitionEquityInterestIssuedOrIssuableValueAssigned" xlink:label="us-gaap_BusinessAcquisitionEquityInterestIssuedOrIssuableValueAssigned"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessAcquisitionEquityInterestIssuedOrIssuableValueAssigned_lbl" xml:lang="en-US" id="id_12960622_2433697_1_1">Business Acquisition, Equity Interest Issued or Issuable, Value Assigned</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessAcquisitionEquityInterestIssuedOrIssuableValueAssigned_lbl" xml:lang="en-US" id="id_12960622_2433697_2_1">Payments to acquire business by issue of common stock</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessAcquisitionEquityInterestIssuedOrIssuableValueAssigned" xlink:to="us-gaap_BusinessAcquisitionEquityInterestIssuedOrIssuableValueAssigned_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued" xlink:label="us-gaap_BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued_lbl" xml:lang="en-US" id="id_12960622_2433256_1_1">Business Acquisition, Equity Interest Issued or Issuable, Number of Shares</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued_lbl" xml:lang="en-US" id="id_12960622_2433256_2_1">Number of shares of common stock issued</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued" xlink:to="us-gaap_BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:label="us-gaap_BusinessAcquisitionLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessAcquisitionLineItems_lbl" xml:lang="en-US" id="id_12960622_2433478_1_1">Business Acquisition [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessAcquisitionLineItems_lbl" xml:lang="en-US" id="id_12960622_2433478_2_1">Business Acquisition [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessAcquisitionLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount" xlink:label="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount_lbl" xml:lang="en-US" id="id_12960622_2433700_1_1">Business Acquisition, Goodwill, Expected Tax Deductible Amount</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount_lbl" xml:lang="en-US" id="id_12960622_2433700_2_1">Goodwill deductible for tax purpose</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount" xlink:to="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_BusinessCombinationConsiderationTransferred1" xlink:label="us-gaap_BusinessCombinationConsiderationTransferred1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessCombinationConsiderationTransferred1_lbl" xml:lang="en-US" id="id_12960622_2433937_1_1">Business Combination, Consideration Transferred</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessCombinationConsiderationTransferred1_lbl" xml:lang="en-US" id="id_12960622_2433937_2_1">Total business acquisition consideration, net of cash acquired</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessCombinationConsiderationTransferred1" xlink:to="us-gaap_BusinessCombinationConsiderationTransferred1_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_BusinessCombinationContingentConsiderationArrangementsDescription" xlink:label="us-gaap_BusinessCombinationContingentConsiderationArrangementsDescription"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessCombinationContingentConsiderationArrangementsDescription_lbl" xml:lang="en-US" id="id_12960622_2433505_1_1">Business Combination, Contingent Consideration Arrangements, Description</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessCombinationContingentConsiderationArrangementsDescription_lbl" xml:lang="en-US" id="id_12960622_2433505_2_1">Business combination contingent consideration arrangements description</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessCombinationContingentConsiderationArrangementsDescription" xlink:to="us-gaap_BusinessCombinationContingentConsiderationArrangementsDescription_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets_lbl" xml:lang="en-US" id="id_12960622_2433287_2_1">Current assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentLiabilities" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentLiabilities"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentLiabilities_lbl" xml:lang="en-US" id="id_12960622_2433289_14_1">Current liabilities</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedDeferredTaxLiabilitiesNoncurrent" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedDeferredTaxLiabilitiesNoncurrent"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedOtherNoncurrentAssets_lbl" xml:lang="en-US" id="id_12960622_2433301_2_1">Other noncurrent assets</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CapitalLeaseObligationsIncurred_lbl" xml:lang="en-US" id="id_12960622_2433765_2_1">Equipment financed through capital leases</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CapitalLeaseObligationsIncurred" xlink:to="us-gaap_CapitalLeaseObligationsIncurred_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CapitalLeaseObligationsNoncurrent" xlink:label="us-gaap_CapitalLeaseObligationsNoncurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CapitalLeaseObligationsNoncurrent_lbl" xml:lang="en-US" id="id_12960622_2433344_1_1">Capital Lease Obligations, Noncurrent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CapitalLeaseObligationsNoncurrent_lbl" xml:lang="en-US" id="id_12960622_2433344_2_1">Long-term portion</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CapitalLeaseObligationsNoncurrent" xlink:to="us-gaap_CapitalLeaseObligationsNoncurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent_lbl" xml:lang="en-US" id="id_12960622_2434229_1_1">Capital Leases, Future Minimum Payments Due, Next Twelve Months</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent_lbl" xml:lang="en-US" id="id_12960622_2434229_2_1">2018</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent" xlink:to="us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CapitalLeasesFutureMinimumPaymentsDueInFourYears" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInFourYears"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInFourYears_lbl" xml:lang="en-US" id="id_12960622_2433767_1_1">Capital Leases, Future Minimum Payments Due in Four Years</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInFourYears_lbl" xml:lang="en-US" id="id_12960622_2433767_2_1">2021</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInFourYears" xlink:to="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInFourYears_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears_lbl" xml:lang="en-US" id="id_12960622_2433348_1_1">Capital Leases, Future Minimum Payments Due in Three Years</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears_lbl" xml:lang="en-US" id="id_12960622_2433348_2_1">2020</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears" xlink:to="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears_lbl" xml:lang="en-US" id="id_12960622_2434664_1_1">Capital Leases, Future Minimum Payments Due in Two Years</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears_lbl" xml:lang="en-US" id="id_12960622_2434664_2_1">2019</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears" xlink:to="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CashAcquiredFromAcquisition" xlink:label="us-gaap_CashAcquiredFromAcquisition"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashAcquiredFromAcquisition_lbl" xml:lang="en-US" id="id_12960622_2434454_1_1">Cash Acquired from Acquisition</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CashAcquiredFromAcquisition_lbl" xml:lang="en-US" id="id_12960622_2434454_2_1">Cash acquired from acquisition</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashAcquiredFromAcquisition" xlink:to="us-gaap_CashAcquiredFromAcquisition_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:label="us-gaap_CashAndCashEquivalentsAtCarryingValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashAndCashEquivalentsAtCarryingValue_lbl" xml:lang="en-US" id="id_12960622_2434030_1_1">Cash and Cash Equivalents, at Carrying Value</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CashAndCashEquivalentsAtCarryingValue_lbl" xml:lang="en-US" id="id_12960622_2434030_2_1">Cash and cash equivalents</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:to="us-gaap_CashAndCashEquivalentsAtCarryingValue_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_CashAndCashEquivalentsMaturityDescription" xlink:label="md_CashAndCashEquivalentsMaturityDescription"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_CashAndCashEquivalentsMaturityDescription_lbl" xml:lang="en-US" id="id_12960622_2615353_3_1">Cash and cash equivalents maturity description.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_CashAndCashEquivalentsMaturityDescription_lbl" xml:lang="en-US" id="id_12960622_2615353_1_1">Cash And Cash Equivalents Maturity Description</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_CashAndCashEquivalentsMaturityDescription_lbl" xml:lang="en-US" id="id_12960622_2615353_2_1">Cash and cash equivalents maturity description</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_CashAndCashEquivalentsMaturityDescription" xlink:to="md_CashAndCashEquivalentsMaturityDescription_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease" xlink:label="us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease_lbl" xml:lang="en-US" id="id_12960622_2434458_1_1">Cash and Cash Equivalents, Period Increase (Decrease)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease_lbl" xml:lang="en-US" id="id_12960622_2434458_6_1">Net increase in cash and cash equivalents</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease" xlink:to="us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CashAndCashEquivalentsPolicyTextBlock" xlink:label="us-gaap_CashAndCashEquivalentsPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashAndCashEquivalentsPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2434270_1_1">Cash and Cash Equivalents, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CashAndCashEquivalentsPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2434270_2_1">Cash and Cash Equivalents</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashAndCashEquivalentsPolicyTextBlock" xlink:to="us-gaap_CashAndCashEquivalentsPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy" xlink:label="us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy_lbl" xml:lang="en-US" id="id_12960622_2434271_1_1">Cash and Cash Equivalents, Restricted Cash and Cash Equivalents, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy_lbl" xml:lang="en-US" id="id_12960622_2434271_2_1">Restricted Cash</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy" xlink:to="us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents_lbl" xml:lang="en-US" id="id_12960622_2434043_1_1">Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodEndLabel" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents_lbl" xml:lang="en-US" id="id_12960622_2434043_4_1">Cash, cash equivalents and restricted cash at end of year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodStartLabel" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents_lbl" xml:lang="en-US" id="id_12960622_2434043_5_1">Cash, cash equivalents and restricted cash at beginning of year</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract" xlink:label="us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract_lbl" xml:lang="en-US" id="id_12960622_2434712_1_1">Cash Flow, Noncash Investing and Financing Activities Disclosure [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract_lbl" xml:lang="en-US" id="id_12960622_2434712_2_1">Non-cash investing and financing activities:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract" xlink:to="us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CashSurrenderValueFairValueDisclosure" xlink:label="us-gaap_CashSurrenderValueFairValueDisclosure"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashSurrenderValueFairValueDisclosure_lbl" xml:lang="en-US" id="id_12960622_2434300_1_1">Cash Surrender Value, Fair Value Disclosure</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CashSurrenderValueFairValueDisclosure_lbl" xml:lang="en-US" id="id_12960622_2434300_2_1">Cash surrender fair value of life insurance</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashSurrenderValueFairValueDisclosure" xlink:to="us-gaap_CashSurrenderValueFairValueDisclosure_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CertificatesOfDepositMember" xlink:label="us-gaap_CertificatesOfDepositMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CertificatesOfDepositMember_lbl" xml:lang="en-US" id="id_12960622_2434508_1_1">Certificates of Deposit [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CertificatesOfDepositMember_lbl" xml:lang="en-US" id="id_12960622_2434508_2_1">Certificates of Deposit [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CertificatesOfDepositMember" xlink:to="us-gaap_CertificatesOfDepositMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_ChangeInControlMember" xlink:label="md_ChangeInControlMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ChangeInControlMember_lbl" xml:lang="en-US" id="id_12960622_2694761_3_1">Change in control.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ChangeInControlMember_lbl" xml:lang="en-US" id="id_12960622_2694761_1_1">Change In Control [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ChangeInControlMember_lbl" xml:lang="en-US" id="id_12960622_2694761_2_1">Change In Control [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ChangeInControlMember" xlink:to="md_ChangeInControlMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CommitmentsAndContingencies" xlink:label="us-gaap_CommitmentsAndContingencies"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CommitmentsAndContingencies_lbl" xml:lang="en-US" id="id_12960622_2434162_1_1">Commitments and Contingencies</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CommitmentsAndContingencies_lbl" xml:lang="en-US" id="id_12960622_2434162_2_1">Commitments and contingencies</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CommitmentsAndContingencies" xlink:to="us-gaap_CommitmentsAndContingencies_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:label="us-gaap_CommitmentsAndContingenciesDisclosureAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CommitmentsAndContingenciesDisclosureAbstract_lbl" xml:lang="en-US" id="id_12960622_2434560_1_1">Commitments and Contingencies Disclosure [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CommitmentsAndContingenciesDisclosureAbstract_lbl" xml:lang="en-US" id="id_12960622_2434560_2_1">Commitments and Contingencies Disclosure [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_CommitmentsAndContingenciesDisclosureAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureTextBlock" xlink:label="us-gaap_CommitmentsAndContingenciesDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CommitmentsAndContingenciesDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2434393_1_1">Commitments and Contingencies Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CommitmentsAndContingenciesDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2434393_2_1">Commitments and Contingencies</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureTextBlock" xlink:to="us-gaap_CommitmentsAndContingenciesDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CommonStockCapitalSharesReservedForFutureIssuance" xlink:label="us-gaap_CommonStockCapitalSharesReservedForFutureIssuance"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CommonStockCapitalSharesReservedForFutureIssuance_lbl" xml:lang="en-US" id="id_12960622_2434570_1_1">Common Stock, Capital Shares Reserved for Future Issuance</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CommonStockCapitalSharesReservedForFutureIssuance_lbl" xml:lang="en-US" id="id_12960622_2434570_2_1">Common stock, reserved for issuance</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CommonStockCapitalSharesReservedForFutureIssuance" xlink:to="us-gaap_CommonStockCapitalSharesReservedForFutureIssuance_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_CommonStockLineItems" xlink:label="md_CommonStockLineItems"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_CommonStockLineItems_lbl" xml:lang="en-US" id="id_12960622_2469515_1_1">Common Stock [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_CommonStockLineItems_lbl" xml:lang="en-US" id="id_12960622_2469515_2_1">Common Stock [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_CommonStockLineItems" xlink:to="md_CommonStockLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CommonStockMember" xlink:label="us-gaap_CommonStockMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CommonStockMember_lbl" xml:lang="en-US" id="id_12960622_2434572_1_1">Common Stock [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CommonStockMember_lbl" xml:lang="en-US" id="id_12960622_2434572_2_1">Common Stock [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CommonStockMember" xlink:to="us-gaap_CommonStockMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CommonStockParOrStatedValuePerShare" xlink:label="us-gaap_CommonStockParOrStatedValuePerShare"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CommonStockParOrStatedValuePerShare_lbl" xml:lang="en-US" id="id_12960622_2434835_1_1">Common Stock, Par or Stated Value Per Share</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CommonStockParOrStatedValuePerShare_lbl" xml:lang="en-US" id="id_12960622_2434835_2_1">Common stock, par value</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CommonStockParOrStatedValuePerShare" xlink:to="us-gaap_CommonStockParOrStatedValuePerShare_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_CommonStockRepurchasesTextBlock" xlink:label="md_CommonStockRepurchasesTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_CommonStockRepurchasesTextBlock_lbl" xml:lang="en-US" id="id_12960622_2760979_3_1">Entire disclosure of common stock repurchases.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_CommonStockRepurchasesTextBlock_lbl" xml:lang="en-US" id="id_12960622_2760979_1_1">Common Stock Repurchases [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_CommonStockRepurchasesTextBlock_lbl" xml:lang="en-US" id="id_12960622_2760979_2_1">Common Stock Repurchase Programs</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_CommonStockRepurchasesTextBlock" xlink:to="md_CommonStockRepurchasesTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_CommonStockShareRepurchasesPolicyTextBlock" xlink:label="md_CommonStockShareRepurchasesPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_CommonStockShareRepurchasesPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2769726_3_1">Common stock share repurchases policy.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_CommonStockShareRepurchasesPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2769726_1_1">Common Stock Share Repurchases [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_CommonStockShareRepurchasesPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2769726_2_1">Common Stock Repurchases</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_CommonStockShareRepurchasesPolicyTextBlock" xlink:to="md_CommonStockShareRepurchasesPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CommonStockSharesAuthorized" xlink:label="us-gaap_CommonStockSharesAuthorized"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CommonStockSharesAuthorized_lbl" xml:lang="en-US" id="id_12960622_2434172_1_1">Common Stock, Shares Authorized</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CommonStockSharesAuthorized_lbl" xml:lang="en-US" id="id_12960622_2434172_2_1">Common stock, aggregate shares authorized</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/verboseLabel" xlink:label="us-gaap_CommonStockSharesAuthorized_lbl" xml:lang="en-US" id="id_12960622_2434172_12_1">Common stock, shares authorized</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CommonStockSharesAuthorized" xlink:to="us-gaap_CommonStockSharesAuthorized_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CommonStockSharesIssued" xlink:label="us-gaap_CommonStockSharesIssued"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CommonStockSharesIssued_lbl" xml:lang="en-US" id="id_12960622_2434837_1_1">Common Stock, Shares, Issued</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CommonStockSharesIssued_lbl" xml:lang="en-US" id="id_12960622_2434837_2_1">Common stock, shares issued</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CommonStockSharesIssued" xlink:to="us-gaap_CommonStockSharesIssued_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CommonStockSharesOutstanding" xlink:label="us-gaap_CommonStockSharesOutstanding"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CommonStockSharesOutstanding_lbl" xml:lang="en-US" id="id_12960622_2434173_1_1">Common Stock, Shares, Outstanding</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CommonStockSharesOutstanding_lbl" xml:lang="en-US" id="id_12960622_2434173_2_1">Common stock, shares outstanding</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CommonStockSharesOutstanding" xlink:to="us-gaap_CommonStockSharesOutstanding_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_CommonStockTable" xlink:label="md_CommonStockTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_CommonStockTable_lbl" xml:lang="en-US" id="id_12960622_2648660_3_1">Common Stock [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_CommonStockTable_lbl" xml:lang="en-US" id="id_12960622_2648660_1_1">Common Stock [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_CommonStockTable_lbl" xml:lang="en-US" id="id_12960622_2648660_2_1">Common Stock [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_CommonStockTable" xlink:to="md_CommonStockTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CommonStockValue" xlink:label="us-gaap_CommonStockValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CommonStockValue_lbl" xml:lang="en-US" id="id_12960622_2434840_1_1">Common Stock, Value, Issued</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CommonStockValue_lbl" xml:lang="en-US" id="id_12960622_2434840_2_1">Common stock; $.01 par value; 200,000 shares authorized; 93,721 and 93,718 shares issued and outstanding, respectively</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CommonStockValue" xlink:to="us-gaap_CommonStockValue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CompensationAndRetirementDisclosureAbstract" xlink:label="us-gaap_CompensationAndRetirementDisclosureAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CompensationAndRetirementDisclosureAbstract_lbl" xml:lang="en-US" id="id_12960622_2434418_1_1">Retirement Benefits [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CompensationAndRetirementDisclosureAbstract_lbl" xml:lang="en-US" id="id_12960622_2434418_2_1">Retirement Benefits [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CompensationAndRetirementDisclosureAbstract" xlink:to="us-gaap_CompensationAndRetirementDisclosureAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ComputerEquipmentMember" xlink:label="us-gaap_ComputerEquipmentMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ComputerEquipmentMember_lbl" xml:lang="en-US" id="id_12960622_2434586_1_1">Computer Equipment [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ComputerEquipmentMember_lbl" xml:lang="en-US" id="id_12960622_2434586_2_1">Computer Equipment [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ComputerEquipmentMember" xlink:to="us-gaap_ComputerEquipmentMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ConcentrationRiskBenchmarkDomain" xlink:label="us-gaap_ConcentrationRiskBenchmarkDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ConcentrationRiskBenchmarkDomain_lbl" xml:lang="en-US" id="id_12960622_2434191_1_1">Concentration Risk Benchmark [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ConcentrationRiskBenchmarkDomain_lbl" xml:lang="en-US" id="id_12960622_2434191_2_1">Concentration Risk Benchmark [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ConcentrationRiskBenchmarkDomain" xlink:to="us-gaap_ConcentrationRiskBenchmarkDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:label="us-gaap_ConcentrationRiskByBenchmarkAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ConcentrationRiskByBenchmarkAxis_lbl" xml:lang="en-US" id="id_12960622_2434587_1_1">Concentration Risk Benchmark [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ConcentrationRiskByBenchmarkAxis_lbl" xml:lang="en-US" id="id_12960622_2434587_2_1">Concentration Risk Benchmark [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:to="us-gaap_ConcentrationRiskByBenchmarkAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ConcentrationRiskByTypeAxis" xlink:label="us-gaap_ConcentrationRiskByTypeAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ConcentrationRiskByTypeAxis_lbl" xml:lang="en-US" id="id_12960622_2434588_1_1">Concentration Risk Type [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ConcentrationRiskByTypeAxis_lbl" xml:lang="en-US" id="id_12960622_2434588_2_1">Concentration Risk Type [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ConcentrationRiskByTypeAxis" xlink:to="us-gaap_ConcentrationRiskByTypeAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ConcentrationRiskPercentage1" xlink:label="us-gaap_ConcentrationRiskPercentage1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ConcentrationRiskPercentage1_lbl" xml:lang="en-US" id="id_12960622_2434595_1_1">Concentration Risk, Percentage</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ConcentrationRiskPercentage1_lbl" xml:lang="en-US" id="id_12960622_2434595_2_1">Net revenue in percentage</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/verboseLabel" xlink:label="us-gaap_ConcentrationRiskPercentage1_lbl" xml:lang="en-US" id="id_12960622_2434595_12_1">Percentage of net accounts receivable</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ConcentrationRiskPercentage1" xlink:to="us-gaap_ConcentrationRiskPercentage1_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ConcentrationRiskTypeDomain" xlink:label="us-gaap_ConcentrationRiskTypeDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ConcentrationRiskTypeDomain_lbl" xml:lang="en-US" id="id_12960622_2434432_1_1">Concentration Risk Type [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ConcentrationRiskTypeDomain_lbl" xml:lang="en-US" id="id_12960622_2434432_2_1">Concentration Risk Type [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ConcentrationRiskTypeDomain" xlink:to="us-gaap_ConcentrationRiskTypeDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ConsolidationPolicyTextBlock" xlink:label="us-gaap_ConsolidationPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ConsolidationPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2434219_1_1">Consolidation, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ConsolidationPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2434219_2_1">Principles of Presentation</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ConsolidationPolicyTextBlock" xlink:to="us-gaap_ConsolidationPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ContingentConsiderationByTypeAxis" xlink:label="us-gaap_ContingentConsiderationByTypeAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ContingentConsiderationByTypeAxis_lbl" xml:lang="en-US" id="id_12960622_2435314_1_1">Contingent Consideration by Type [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ContingentConsiderationByTypeAxis_lbl" xml:lang="en-US" id="id_12960622_2435314_2_1">Contingent Consideration by Type [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ContingentConsiderationByTypeAxis" xlink:to="us-gaap_ContingentConsiderationByTypeAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_ContingentConsiderationMember" xlink:label="md_ContingentConsiderationMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ContingentConsiderationMember_lbl" xml:lang="en-US" id="id_12960622_2658296_3_1">Contingent consideration.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ContingentConsiderationMember_lbl" xml:lang="en-US" id="id_12960622_2658296_1_1">Contingent Consideration [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ContingentConsiderationMember_lbl" xml:lang="en-US" id="id_12960622_2658296_2_1">Contingent Consideration [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ContingentConsiderationMember" xlink:to="md_ContingentConsiderationMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ContingentConsiderationTypeDomain" xlink:label="us-gaap_ContingentConsiderationTypeDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ContingentConsiderationTypeDomain_lbl" xml:lang="en-US" id="id_12960622_2435532_1_1">Contingent Consideration Type [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ContingentConsiderationTypeDomain_lbl" xml:lang="en-US" id="id_12960622_2435532_2_1">Contingent Consideration Type [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ContingentConsiderationTypeDomain" xlink:to="us-gaap_ContingentConsiderationTypeDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_ContractualAdjustmentsAndUncollectibles" xlink:label="md_ContractualAdjustmentsAndUncollectibles"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ContractualAdjustmentsAndUncollectibles_lbl" xml:lang="en-US" id="id_12960622_2552258_3_1">Contractual adjustments and uncollectibles.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ContractualAdjustmentsAndUncollectibles_lbl" xml:lang="en-US" id="id_12960622_2552258_1_1">Contractual Adjustments And Uncollectibles</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="md_ContractualAdjustmentsAndUncollectibles_lbl" xml:lang="en-US" id="id_12960622_2552258_14_1">Contractual adjustments and uncollectibles</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ContractualAdjustmentsAndUncollectibles" xlink:to="md_ContractualAdjustmentsAndUncollectibles_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CreditFacilityAxis" xlink:label="us-gaap_CreditFacilityAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CreditFacilityAxis_lbl" xml:lang="en-US" id="id_12960622_2435419_1_1">Credit Facility [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CreditFacilityAxis_lbl" xml:lang="en-US" id="id_12960622_2435419_2_1">Credit Facility [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CreditFacilityDomain" xlink:label="us-gaap_CreditFacilityDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CreditFacilityDomain_lbl" xml:lang="en-US" id="id_12960622_2435420_1_1">Credit Facility [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CreditFacilityDomain_lbl" xml:lang="en-US" id="id_12960622_2435420_2_1">Credit Facility [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="us-gaap_CreditFacilityDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CurrentFederalTaxExpenseBenefit" xlink:label="us-gaap_CurrentFederalTaxExpenseBenefit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CurrentFederalTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_12960622_2435000_1_1">Current Federal Tax Expense (Benefit)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CurrentFederalTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_12960622_2435000_2_1">Federal, Current</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CurrentFederalTaxExpenseBenefit" xlink:to="us-gaap_CurrentFederalTaxExpenseBenefit_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.sec.gov/dei/2014/dei-2014-01-31.xsd#dei_CurrentFiscalYearEndDate" xlink:label="dei_CurrentFiscalYearEndDate"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_CurrentFiscalYearEndDate_lbl" xml:lang="en-US" id="id_12960622_2435642_1_1">Current Fiscal Year End Date</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_CurrentFiscalYearEndDate_lbl" xml:lang="en-US" id="id_12960622_2435642_2_1">Current Fiscal Year End Date</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_CurrentFiscalYearEndDate" xlink:to="dei_CurrentFiscalYearEndDate_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CurrentStateAndLocalTaxExpenseBenefit" xlink:label="us-gaap_CurrentStateAndLocalTaxExpenseBenefit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CurrentStateAndLocalTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_12960622_2435159_1_1">Current State and Local Tax Expense (Benefit)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CurrentStateAndLocalTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_12960622_2435159_2_1">State, Current</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CurrentStateAndLocalTaxExpenseBenefit" xlink:to="us-gaap_CurrentStateAndLocalTaxExpenseBenefit_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_CustomerRelationshipsMember" xlink:label="us-gaap_CustomerRelationshipsMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CustomerRelationshipsMember_lbl" xml:lang="en-US" id="id_12960622_2435168_1_1">Customer Relationships [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CustomerRelationshipsMember_lbl" xml:lang="en-US" id="id_12960622_2435168_2_1">Customer Relationships [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CustomerRelationshipsMember" xlink:to="us-gaap_CustomerRelationshipsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock" xlink:label="us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock_lbl" xml:lang="en-US" id="id_12960622_2435459_1_1">Debt and Capital Leases Disclosures [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock_lbl" xml:lang="en-US" id="id_12960622_2435459_2_1">Line of Credit, Long-Term Debt and Capital Lease Obligations</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock" xlink:to="us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:label="us-gaap_DebtDisclosureAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtDisclosureAbstract_lbl" xml:lang="en-US" id="id_12960622_2435671_1_1">Debt Disclosure [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtDisclosureAbstract_lbl" xml:lang="en-US" id="id_12960622_2435671_2_1">Debt Disclosure [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_DebtDisclosureAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DebtInstrumentAxis" xlink:label="us-gaap_DebtInstrumentAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentAxis_lbl" xml:lang="en-US" id="id_12960622_2435465_1_1">Debt Instrument [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentAxis_lbl" xml:lang="en-US" id="id_12960622_2435465_2_1">Debt Instrument [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentAxis" xlink:to="us-gaap_DebtInstrumentAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DebtInstrumentBasisSpreadOnVariableRate1" xlink:label="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1_lbl" xml:lang="en-US" id="id_12960622_2435466_1_1">Debt Instrument, Basis Spread on Variable Rate</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1_lbl" xml:lang="en-US" id="id_12960622_2435466_2_1">Debt instrument, variable interest rate</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1" xlink:to="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DebtInstrumentCarryingAmount" xlink:label="us-gaap_DebtInstrumentCarryingAmount"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentCarryingAmount_lbl" xml:lang="en-US" id="id_12960622_2435673_1_1">Long-term Debt, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentCarryingAmount_lbl" xml:lang="en-US" id="id_12960622_2435673_2_1">Debt instrument principal amount</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentCarryingAmount" xlink:to="us-gaap_DebtInstrumentCarryingAmount_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_DebtInstrumentCarryingAmountCurrent" xlink:label="md_DebtInstrumentCarryingAmountCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DebtInstrumentCarryingAmountCurrent_lbl" xml:lang="en-US" id="id_12960622_2556756_3_1">Debt instrument carrying amount current.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_DebtInstrumentCarryingAmountCurrent_lbl" xml:lang="en-US" id="id_12960622_2556756_1_1">Debt Instrument Carrying Amount Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="md_DebtInstrumentCarryingAmountCurrent_lbl" xml:lang="en-US" id="id_12960622_2556756_14_1">Less: Current portion, principal</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_DebtInstrumentCarryingAmountCurrent" xlink:to="md_DebtInstrumentCarryingAmountCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_DebtInstrumentCarryingAmountNonCurrent" xlink:label="md_DebtInstrumentCarryingAmountNonCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DebtInstrumentCarryingAmountNonCurrent_lbl" xml:lang="en-US" id="id_12960622_2502191_3_1">Debt instrument carrying amount non current.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_DebtInstrumentCarryingAmountNonCurrent_lbl" xml:lang="en-US" id="id_12960622_2502191_1_1">Debt Instrument Carrying Amount Non Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_DebtInstrumentCarryingAmountNonCurrent_lbl" xml:lang="en-US" id="id_12960622_2502191_2_1">Debt instrument principal long-term portion</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_DebtInstrumentCarryingAmountNonCurrent" xlink:to="md_DebtInstrumentCarryingAmountNonCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DebtInstrumentDescriptionOfVariableRateBasis" xlink:label="us-gaap_DebtInstrumentDescriptionOfVariableRateBasis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentDescriptionOfVariableRateBasis_lbl" xml:lang="en-US" id="id_12960622_2435678_1_1">Debt Instrument, Description of Variable Rate Basis</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentDescriptionOfVariableRateBasis_lbl" xml:lang="en-US" id="id_12960622_2435678_2_1">Debt instrument, interest rate</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentDescriptionOfVariableRateBasis" xlink:to="us-gaap_DebtInstrumentDescriptionOfVariableRateBasis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DebtInstrumentFaceAmount" xlink:label="us-gaap_DebtInstrumentFaceAmount"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentFaceAmount_lbl" xml:lang="en-US" id="id_12960622_2435679_1_1">Debt Instrument, Face Amount</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentFaceAmount_lbl" xml:lang="en-US" id="id_12960622_2435679_2_1">Aggregate principal amount of debt</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentFaceAmount" xlink:to="us-gaap_DebtInstrumentFaceAmount_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DebtInstrumentInterestRateStatedPercentage" xlink:label="us-gaap_DebtInstrumentInterestRateStatedPercentage"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentInterestRateStatedPercentage_lbl" xml:lang="en-US" id="id_12960622_2435053_1_1">Debt Instrument, Interest Rate, Stated Percentage</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentInterestRateStatedPercentage_lbl" xml:lang="en-US" id="id_12960622_2435053_2_1">Debt instrument interest rate</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentInterestRateStatedPercentage" xlink:to="us-gaap_DebtInstrumentInterestRateStatedPercentage_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DebtInstrumentLineItems" xlink:label="us-gaap_DebtInstrumentLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentLineItems_lbl" xml:lang="en-US" id="id_12960622_2435200_1_1">Debt Instrument [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentLineItems_lbl" xml:lang="en-US" id="id_12960622_2435200_2_1">Debt Instrument [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DebtInstrumentMaturityDateDescription" xlink:label="us-gaap_DebtInstrumentMaturityDateDescription"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentMaturityDateDescription_lbl" xml:lang="en-US" id="id_12960622_2435484_1_1">Debt Instrument, Maturity Date, Description</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentMaturityDateDescription_lbl" xml:lang="en-US" id="id_12960622_2435484_2_1">Debt instrument maturity date description</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentMaturityDateDescription" xlink:to="us-gaap_DebtInstrumentMaturityDateDescription_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_DebtInstrumentMaturityYear" xlink:label="md_DebtInstrumentMaturityYear"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DebtInstrumentMaturityYear_lbl" xml:lang="en-US" id="id_12960622_2622240_3_1">Debt instrument maturity year.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_DebtInstrumentMaturityYear_lbl" xml:lang="en-US" id="id_12960622_2622240_1_1">Debt Instrument Maturity Year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_DebtInstrumentMaturityYear_lbl" xml:lang="en-US" id="id_12960622_2622240_2_1">Debt instrument, maturity year</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_DebtInstrumentMaturityYear" xlink:to="md_DebtInstrumentMaturityYear_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DebtInstrumentNameDomain" xlink:label="us-gaap_DebtInstrumentNameDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentNameDomain_lbl" xml:lang="en-US" id="id_12960622_2435683_1_1">Debt Instrument, Name [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentNameDomain_lbl" xml:lang="en-US" id="id_12960622_2435683_2_1">Debt Instrument, Name [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="us-gaap_DebtInstrumentNameDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodAxis" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodAxis_lbl" xml:lang="en-US" id="id_12960622_2435686_1_1">Debt Instrument, Redemption, Period [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodAxis_lbl" xml:lang="en-US" id="id_12960622_2435686_2_1">Debt Instrument, Redemption, Period [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodAxis" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_DebtInstrumentRedemptionPeriodBeforeTwoThousandEighteenMember" xlink:label="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandEighteenMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandEighteenMember_lbl" xml:lang="en-US" id="id_12960622_2694748_3_1">Debt instrument redemption period before two thousand eighteen.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandEighteenMember_lbl" xml:lang="en-US" id="id_12960622_2694748_1_1">Debt Instrument Redemption Period Before Two Thousand Eighteen [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandEighteenMember_lbl" xml:lang="en-US" id="id_12960622_2694748_2_1">Redemption Before 2018 [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandEighteenMember" xlink:to="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandEighteenMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodDomain_lbl" xml:lang="en-US" id="id_12960622_2435205_1_1">Debt Instrument, Redemption, Period [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodDomain_lbl" xml:lang="en-US" id="id_12960622_2435205_2_1">Debt Instrument, Redemption, Period [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_DebtInstrumentRedemptionPeriodFourAndThereafterMember" xlink:label="md_DebtInstrumentRedemptionPeriodFourAndThereafterMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DebtInstrumentRedemptionPeriodFourAndThereafterMember_lbl" xml:lang="en-US" id="id_12960622_2750800_3_1">Debt instrument redemption period four and thereafter.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_DebtInstrumentRedemptionPeriodFourAndThereafterMember_lbl" xml:lang="en-US" id="id_12960622_2750800_1_1">Debt Instrument Redemption Period Four And Thereafter [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_DebtInstrumentRedemptionPeriodFourAndThereafterMember_lbl" xml:lang="en-US" id="id_12960622_2750800_2_1">Redemption in 2021 and Thereafter [Member]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DeconsolidationPercentage_lbl" xml:lang="en-US" id="id_12960622_2790842_3_1">Deconsolidation percentage.</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DecreaseInUnrecognizedTaxBenefitsIsReasonablyPossible" xlink:label="us-gaap_DecreaseInUnrecognizedTaxBenefitsIsReasonablyPossible"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DecreaseInUnrecognizedTaxBenefitsIsReasonablyPossible_lbl" xml:lang="en-US" id="id_12960622_2435513_1_1">Decrease in Unrecognized Tax Benefits is Reasonably Possible</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DeferredFederalIncomeTaxExpenseBenefit" xlink:label="us-gaap_DeferredFederalIncomeTaxExpenseBenefit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredFederalIncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_12960622_2436177_1_1">Deferred Federal Income Tax Expense (Benefit)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredFederalIncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_12960622_2436177_2_1">Federal, Deferred</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredFederalIncomeTaxExpenseBenefit" xlink:to="us-gaap_DeferredFederalIncomeTaxExpenseBenefit_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredIncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_12960622_2436191_1_1">Deferred Income Tax Expense (Benefit)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredIncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_12960622_2436191_2_1">Deferred income taxes</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredIncomeTaxLiabilities_lbl" xml:lang="en-US" id="id_12960622_2435251_1_1">Deferred Tax Liabilities, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedTotalLabel" xlink:label="us-gaap_DeferredIncomeTaxLiabilities_lbl" xml:lang="en-US" id="id_12960622_2435251_19_1">Total deferred tax liabilities</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit" xlink:label="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_12960622_2436215_1_1">Deferred State and Local Income Tax Expense (Benefit)</label>
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    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit" xlink:to="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DeferredTaxAssetsGross" xlink:label="us-gaap_DeferredTaxAssetsGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsGross_lbl" xml:lang="en-US" id="id_12960622_2435282_1_1">Deferred Tax Assets, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_DeferredTaxAssetsGross_lbl" xml:lang="en-US" id="id_12960622_2435282_6_1">Deferred tax assets before valuation allowance</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DeferredTaxAssetsNet" xlink:label="us-gaap_DeferredTaxAssetsNet"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsNet_lbl" xml:lang="en-US" id="id_12960622_2435284_1_1">Deferred Tax Assets, Net of Valuation Allowance</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_DeferredTaxAssetsNet_lbl" xml:lang="en-US" id="id_12960622_2435284_6_1">Deferred tax assets, net of valuation allowance</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DeferredTaxAssetsOperatingLossCarryforwards" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards_lbl" xml:lang="en-US" id="id_12960622_2435806_1_1">Deferred Tax Assets, Operating Loss Carryforwards</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards_lbl" xml:lang="en-US" id="id_12960622_2435806_2_1">Net operating loss carryforward</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxAssetsOther_lbl" xml:lang="en-US" id="id_12960622_2436223_2_1">Other</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment" xlink:label="us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment_lbl" xml:lang="en-US" id="id_12960622_2436442_1_1">Deferred Tax Assets, Property, Plant and Equipment</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment_lbl" xml:lang="en-US" id="id_12960622_2436442_2_1">Property and equipment</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost_lbl" xml:lang="en-US" id="id_12960622_2436449_1_1">Deferred Tax Assets, Tax Deferred Expense, Compensation and Benefits, Share-based Compensation Cost</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost_lbl" xml:lang="en-US" id="id_12960622_2436449_2_1">Stock-based compensation</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts_lbl" xml:lang="en-US" id="id_12960622_2436451_1_1">Deferred Tax Assets, Tax Deferred Expense, Reserves and Accruals, Allowance for Doubtful Accounts</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts_lbl" xml:lang="en-US" id="id_12960622_2436451_2_1">Allowance for uncollectible accounts</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves_lbl" xml:lang="en-US" id="id_12960622_2436233_2_1">Reserves and accruals</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsValuationAllowance_lbl" xml:lang="en-US" id="id_12960622_2436236_1_1">Deferred Tax Assets, Valuation Allowance</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_DeferredTaxAssetsValuationAllowance_lbl" xml:lang="en-US" id="id_12960622_2436236_14_1">Less: Valuation allowance</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxLiabilitiesNoncurrent_lbl" xml:lang="en-US" id="id_12960622_2435826_2_1">Deferred income taxes</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DefinedContributionPlanCostRecognized_lbl" xml:lang="en-US" id="id_12960622_2435894_2_1">Expense of retirement plans related to the 401(k) Plans</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_Depreciation_lbl" xml:lang="en-US" id="id_12960622_2436329_1_1">Depreciation</label>
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    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_Depreciation" xlink:to="us-gaap_Depreciation_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DepreciationDepletionAndAmortization" xlink:label="us-gaap_DepreciationDepletionAndAmortization"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DepreciationDepletionAndAmortization_lbl" xml:lang="en-US" id="id_12960622_2436331_2_1">Depreciation and amortization</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DepreciationDepletionAndAmortization" xlink:to="us-gaap_DepreciationDepletionAndAmortization_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract_lbl" xml:lang="en-US" id="id_12960622_2437359_1_1">Disclosure of Compensation Related Costs, Share-based Payments [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract_lbl" xml:lang="en-US" id="id_12960622_2437359_2_1">Disclosure of Compensation Related Costs, Share-based Payments [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock_lbl" xml:lang="en-US" id="id_12960622_2437103_2_1">Stock Incentive Plans and Stock Purchase Plans</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" xlink:to="us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_DocumentAndEntityInformationAbstract" xlink:label="md_DocumentAndEntityInformationAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DocumentAndEntityInformationAbstract_lbl" xml:lang="en-US" id="id_12960622_2455411_3_1">Document And Entity Information.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_DocumentAndEntityInformationAbstract_lbl" xml:lang="en-US" id="id_12960622_2455411_1_1">Document And Entity Information [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_DocumentAndEntityInformationAbstract_lbl" xml:lang="en-US" id="id_12960622_2455411_2_1">Document And Entity Information [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="md_DocumentAndEntityInformationAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.sec.gov/dei/2014/dei-2014-01-31.xsd#dei_DocumentFiscalPeriodFocus" xlink:label="dei_DocumentFiscalPeriodFocus"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_DocumentFiscalPeriodFocus_lbl" xml:lang="en-US" id="id_12960622_2437192_1_1">Document Fiscal Period Focus</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_DocumentFiscalPeriodFocus_lbl" xml:lang="en-US" id="id_12960622_2437192_2_1">Document Fiscal Period Focus</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.sec.gov/dei/2014/dei-2014-01-31.xsd#dei_DocumentFiscalYearFocus" xlink:label="dei_DocumentFiscalYearFocus"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_DocumentFiscalYearFocus_lbl" xml:lang="en-US" id="id_12960622_2437193_1_1">Document Fiscal Year Focus</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_DocumentFiscalYearFocus_lbl" xml:lang="en-US" id="id_12960622_2437193_2_1">Document Fiscal Year Focus</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.sec.gov/dei/2014/dei-2014-01-31.xsd#dei_DocumentPeriodEndDate" xlink:label="dei_DocumentPeriodEndDate"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_DocumentPeriodEndDate_lbl" xml:lang="en-US" id="id_12960622_2437438_1_1">Document Period End Date</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_DocumentPeriodEndDate_lbl" xml:lang="en-US" id="id_12960622_2437438_2_1">Document Period End Date</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_DocumentPeriodEndDate" xlink:to="dei_DocumentPeriodEndDate_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_DocumentType_lbl" xml:lang="en-US" id="id_12960622_2437197_1_1">Document Type</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_DocumentType_lbl" xml:lang="en-US" id="id_12960622_2437197_2_1">Document Type</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_DocumentType" xlink:to="dei_DocumentType_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_EarliestTaxYearMember" xlink:label="us-gaap_EarliestTaxYearMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EarliestTaxYearMember_lbl" xml:lang="en-US" id="id_12960622_2436943_1_1">Earliest Tax Year [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EarliestTaxYearMember_lbl" xml:lang="en-US" id="id_12960622_2436943_2_1">Earliest Tax Year [Member]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EarningsPerShareAbstract_lbl" xml:lang="en-US" id="id_12960622_2437464_1_1">Earnings Per Share [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EarningsPerShareAbstract_lbl" xml:lang="en-US" id="id_12960622_2437464_2_1">Net income attributable to MEDNAX, Inc.:</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_EarningsPerShareBasic" xlink:label="us-gaap_EarningsPerShareBasic"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EarningsPerShareBasic_lbl" xml:lang="en-US" id="id_12960622_2437465_1_1">Earnings Per Share, Basic</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EarningsPerShareBasic_lbl" xml:lang="en-US" id="id_12960622_2437465_2_1">Earnings per share, Basic</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EarningsPerShareBasic" xlink:to="us-gaap_EarningsPerShareBasic_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract" xlink:label="us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract_lbl" xml:lang="en-US" id="id_12960622_2437466_1_1">Earnings Per Share, Basic, Other Disclosures [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract_lbl" xml:lang="en-US" id="id_12960622_2437466_2_1">Weighted average common shares:</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_EarningsPerShareDiluted" xlink:label="us-gaap_EarningsPerShareDiluted"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EarningsPerShareDiluted_lbl" xml:lang="en-US" id="id_12960622_2437214_1_1">Earnings Per Share, Diluted</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EarningsPerShareDiluted_lbl" xml:lang="en-US" id="id_12960622_2437214_2_1">Earnings per share, Diluted</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_EarningsPerSharePolicyTextBlock" xlink:label="us-gaap_EarningsPerSharePolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EarningsPerSharePolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2437218_1_1">Earnings Per Share, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EarningsPerSharePolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2437218_2_1">Net Income Per Common Share</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EarningsPerSharePolicyTextBlock" xlink:to="us-gaap_EarningsPerSharePolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_EarningsPerShareTextBlock" xlink:label="us-gaap_EarningsPerShareTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EarningsPerShareTextBlock_lbl" xml:lang="en-US" id="id_12960622_2436955_1_1">Earnings Per Share [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EarningsPerShareTextBlock_lbl" xml:lang="en-US" id="id_12960622_2436955_2_1">Common and Common Equivalent Shares</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization_lbl" xml:lang="en-US" id="id_12960622_2438534_14_1">Accumulated Amortization</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FinitelivedIntangibleAssetsAcquired1_lbl" xml:lang="en-US" id="id_12960622_2439645_1_1">Finite-lived Intangible Assets Acquired</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths_lbl" xml:lang="en-US" id="id_12960622_2438535_1_1">Finite-Lived Intangible Assets, Amortization Expense, Next Twelve Months</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths_lbl" xml:lang="en-US" id="id_12960622_2438535_2_1">Amortization expense for existing other intangible assets, 2018</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2439649_1_1">Finite-lived Intangible Assets Amortization Expense [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2439649_2_1">Amortization Expenses for Existing Intangible Assets for the Next Five Years</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive_lbl" xml:lang="en-US" id="id_12960622_2438731_1_1">Finite-Lived Intangible Assets, Amortization Expense, Year Five</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive_lbl" xml:lang="en-US" id="id_12960622_2438731_2_1">Amortization expense for existing other intangible assets, 2022</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour_lbl" xml:lang="en-US" id="id_12960622_2438537_1_1">Finite-Lived Intangible Assets, Amortization Expense, Year Four</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour_lbl" xml:lang="en-US" id="id_12960622_2438537_2_1">Amortization expense for existing other intangible assets, 2021</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree_lbl" xml:lang="en-US" id="id_12960622_2438732_1_1">Finite-Lived Intangible Assets, Amortization Expense, Year Three</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree_lbl" xml:lang="en-US" id="id_12960622_2438732_2_1">Amortization expense for existing other intangible assets, 2020</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo_lbl" xml:lang="en-US" id="id_12960622_2438733_1_1">Finite-Lived Intangible Assets, Amortization Expense, Year Two</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo_lbl" xml:lang="en-US" id="id_12960622_2438733_2_1">Amortization expense for existing other intangible assets, 2019</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis_lbl" xml:lang="en-US" id="id_12960622_2439650_1_1">Finite-Lived Intangible Assets by Major Class [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis_lbl" xml:lang="en-US" id="id_12960622_2439650_2_1">Finite-Lived Intangible Assets by Major Class [Axis]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsNet_lbl" xml:lang="en-US" id="id_12960622_2438739_2_1">Intangible assets, net</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsNet_lbl" xml:lang="en-US" id="id_12960622_2438739_6_1">Net Carrying Value</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetsNet" xlink:to="us-gaap_FiniteLivedIntangibleAssetsNet_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetUsefulLife" xlink:label="us-gaap_FiniteLivedIntangibleAssetUsefulLife"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetUsefulLife_lbl" xml:lang="en-US" id="id_12960622_2438928_1_1">Finite-Lived Intangible Asset, Useful Life</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetUsefulLife_lbl" xml:lang="en-US" id="id_12960622_2438928_2_1">Intangible assets finite lives</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetUsefulLife" xlink:to="us-gaap_FiniteLivedIntangibleAssetUsefulLife_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" xlink:label="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember_lbl" xml:lang="en-US" id="id_12960622_2705617_3_1">Five point two five percent senior unsecured notes due two thousand twenty three.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember_lbl" xml:lang="en-US" id="id_12960622_2705617_1_1">Five Point Two Five Percent Senior Unsecured Notes Due Two Thousand Twenty Three [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember_lbl" xml:lang="en-US" id="id_12960622_2705617_2_1">5.25% Senior Unsecured Notes Due 2023 [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" xlink:to="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_FixturesAndEquipmentGross" xlink:label="us-gaap_FixturesAndEquipmentGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FixturesAndEquipmentGross_lbl" xml:lang="en-US" id="id_12960622_2438758_1_1">Fixtures and Equipment, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FixturesAndEquipmentGross_lbl" xml:lang="en-US" id="id_12960622_2438758_2_1">Equipment and other</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FixturesAndEquipmentGross" xlink:to="us-gaap_FixturesAndEquipmentGross_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_FurnitureAndFixturesMember" xlink:label="us-gaap_FurnitureAndFixturesMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FurnitureAndFixturesMember_lbl" xml:lang="en-US" id="id_12960622_2439260_1_1">Furniture and Fixtures [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FurnitureAndFixturesMember_lbl" xml:lang="en-US" id="id_12960622_2439260_2_1">Furniture [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FurnitureAndFixturesMember" xlink:to="us-gaap_FurnitureAndFixturesMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_GeneralAndAdministrativeExpense" xlink:label="us-gaap_GeneralAndAdministrativeExpense"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_GeneralAndAdministrativeExpense_lbl" xml:lang="en-US" id="id_12960622_2439776_1_1">General and Administrative Expense</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_GeneralAndAdministrativeExpense_lbl" xml:lang="en-US" id="id_12960622_2439776_2_1">General and administrative expenses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_GeneralAndAdministrativeExpense" xlink:to="us-gaap_GeneralAndAdministrativeExpense_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_Goodwill" xlink:label="us-gaap_Goodwill"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_Goodwill_lbl" xml:lang="en-US" id="id_12960622_2439530_1_1">Goodwill</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_Goodwill_lbl" xml:lang="en-US" id="id_12960622_2439530_2_1">Goodwill</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_Goodwill" xlink:to="us-gaap_Goodwill_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract_lbl" xml:lang="en-US" id="id_12960622_2439342_1_1">Goodwill and Intangible Assets Disclosure [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract_lbl" xml:lang="en-US" id="id_12960622_2439342_2_1">Goodwill and Intangible Assets Disclosure [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2439343_1_1">Goodwill and Intangible Assets Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2439343_2_1">Goodwill and Intangible Assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock" xlink:to="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock" xlink:label="us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2439532_1_1">Goodwill and Intangible Assets, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2439532_2_1">Goodwill and Other Intangible Assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock" xlink:to="us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:label="md_GoodwillAndOtherIntangibleAssetsLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_GoodwillAndOtherIntangibleAssetsLineItems_lbl" xml:lang="en-US" id="id_12960622_2483441_3_1">Goodwill And Other Intangible Assets [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_GoodwillAndOtherIntangibleAssetsLineItems_lbl" xml:lang="en-US" id="id_12960622_2483441_1_1">Goodwill And Other Intangible Assets [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_GoodwillAndOtherIntangibleAssetsLineItems_lbl" xml:lang="en-US" id="id_12960622_2483441_2_1">Goodwill And Other Intangible Assets [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:to="md_GoodwillAndOtherIntangibleAssetsLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_GoodwillAndOtherIntangibleAssetsTable" xlink:label="md_GoodwillAndOtherIntangibleAssetsTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_GoodwillAndOtherIntangibleAssetsTable_lbl" xml:lang="en-US" id="id_12960622_2649155_3_1">Goodwill And Other Intangible Assets [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_GoodwillAndOtherIntangibleAssetsTable_lbl" xml:lang="en-US" id="id_12960622_2649155_1_1">Goodwill And Other Intangible Assets [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_GoodwillAndOtherIntangibleAssetsTable_lbl" xml:lang="en-US" id="id_12960622_2649155_2_1">Goodwill And Other Intangible Assets [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_GoodwillAndOtherIntangibleAssetsTable" xlink:to="md_GoodwillAndOtherIntangibleAssetsTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_GoodwillPeriodIncreaseDecrease" xlink:label="us-gaap_GoodwillPeriodIncreaseDecrease"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_GoodwillPeriodIncreaseDecrease_lbl" xml:lang="en-US" id="id_12960622_2439351_1_1">Goodwill, Period Increase (Decrease)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_GoodwillPeriodIncreaseDecrease_lbl" xml:lang="en-US" id="id_12960622_2439351_2_1">Change in goodwill carrying amount</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_GoodwillPeriodIncreaseDecrease" xlink:to="us-gaap_GoodwillPeriodIncreaseDecrease_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_GoodwillPurchaseAccountingAdjustments" xlink:label="us-gaap_GoodwillPurchaseAccountingAdjustments"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_GoodwillPurchaseAccountingAdjustments_lbl" xml:lang="en-US" id="id_12960622_2439807_1_1">Goodwill, Purchase Accounting Adjustments</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_GoodwillPurchaseAccountingAdjustments_lbl" xml:lang="en-US" id="id_12960622_2439807_2_1">Increase in goodwill resulting from finalization of tax acquisition accounting</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_GoodwillPurchaseAccountingAdjustments" xlink:to="us-gaap_GoodwillPurchaseAccountingAdjustments_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_GovernmentContractsConcentrationRiskMember" xlink:label="us-gaap_GovernmentContractsConcentrationRiskMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_GovernmentContractsConcentrationRiskMember_lbl" xml:lang="en-US" id="id_12960622_2439812_1_1">Government Contracts Concentration Risk [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_GovernmentContractsConcentrationRiskMember_lbl" xml:lang="en-US" id="id_12960622_2439812_2_1">Government Contracts Concentration Risk [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_GovernmentContractsConcentrationRiskMember" xlink:to="us-gaap_GovernmentContractsConcentrationRiskMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_HealthCareOrganizationRevenue" xlink:label="us-gaap_HealthCareOrganizationRevenue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_HealthCareOrganizationRevenue_lbl" xml:lang="en-US" id="id_12960622_2439589_1_1">Health Care Organization, Revenue</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_HealthCareOrganizationRevenue_lbl" xml:lang="en-US" id="id_12960622_2439589_2_1">Net patient service revenue</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_HealthCareOrganizationRevenue_lbl" xml:lang="en-US" id="id_12960622_2439589_6_1">Net revenue</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/verboseLabel" xlink:label="us-gaap_HealthCareOrganizationRevenue_lbl" xml:lang="en-US" id="id_12960622_2439589_12_1">Net revenue</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_HealthCareOrganizationRevenue" xlink:to="us-gaap_HealthCareOrganizationRevenue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_HealthCareOrganizationsAbstract" xlink:label="us-gaap_HealthCareOrganizationsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_HealthCareOrganizationsAbstract_lbl" xml:lang="en-US" id="id_12960622_2439394_1_1">Health Care Organizations [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_HealthCareOrganizationsAbstract_lbl" xml:lang="en-US" id="id_12960622_2439394_2_1">Health Care Organizations [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_HealthCareOrganizationsAbstract" xlink:to="us-gaap_HealthCareOrganizationsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_HealthOrganizationRevenueGross" xlink:label="md_HealthOrganizationRevenueGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_HealthOrganizationRevenueGross_lbl" xml:lang="en-US" id="id_12960622_2563282_3_1">Health organization revenue gross.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_HealthOrganizationRevenueGross_lbl" xml:lang="en-US" id="id_12960622_2563282_1_1">Health Organization Revenue Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_HealthOrganizationRevenueGross_lbl" xml:lang="en-US" id="id_12960622_2563282_2_1">Gross revenue</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_HealthOrganizationRevenueGross" xlink:to="md_HealthOrganizationRevenueGross_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_HeldToMaturitySecuritiesCurrent" xlink:label="us-gaap_HeldToMaturitySecuritiesCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_HeldToMaturitySecuritiesCurrent_lbl" xml:lang="en-US" id="id_12960622_2439599_1_1">Held-to-maturity Securities, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_HeldToMaturitySecuritiesCurrent_lbl" xml:lang="en-US" id="id_12960622_2439599_2_1">Short-Term</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/verboseLabel" xlink:label="us-gaap_HeldToMaturitySecuritiesCurrent_lbl" xml:lang="en-US" id="id_12960622_2439599_12_1">Short-term investments</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_HeldToMaturitySecuritiesCurrent" xlink:to="us-gaap_HeldToMaturitySecuritiesCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount" xlink:label="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount_lbl" xml:lang="en-US" id="id_12960622_2439601_1_1">Held-to-maturity Securities, Debt Maturities, after Five Through Ten Years, Net Carrying Amount</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount_lbl" xml:lang="en-US" id="id_12960622_2439601_2_1">Due after five years through six years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount" xlink:to="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount" xlink:label="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount_lbl" xml:lang="en-US" id="id_12960622_2440511_1_1">Held-to-maturity Securities, Debt Maturities, after One Through Five Years, Net Carrying Amount</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_HospitalContractAdministrativeFees_lbl" xml:lang="en-US" id="id_12960622_2602178_3_1">Hospital contract administrative fees.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_HospitalContractAdministrativeFees_lbl" xml:lang="en-US" id="id_12960622_2602178_1_1">Hospital Contract Administrative Fees</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest_lbl" xml:lang="en-US" id="id_12960622_2440071_2_1">Income before income taxes</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeLossFromEquityMethodInvestments_lbl" xml:lang="en-US" id="id_12960622_2440724_2_1">Equity (losses) in earnings of unconsolidated affiliate</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncomeStatementAbstract_lbl" xml:lang="en-US" id="id_12960622_2440732_1_1">Income Statement [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeStatementAbstract_lbl" xml:lang="en-US" id="id_12960622_2440732_2_1">Income Statement [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_IncomeStatementAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:label="us-gaap_IncomeTaxDisclosureAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncomeTaxDisclosureAbstract_lbl" xml:lang="en-US" id="id_12960622_2440737_1_1">Income Tax Disclosure [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeTaxDisclosureAbstract_lbl" xml:lang="en-US" id="id_12960622_2440737_2_1">Income Tax Disclosure [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_IncomeTaxDisclosureAbstract_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncomeTaxDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2440154_1_1">Income Tax Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeTaxDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2440154_2_1">Income Taxes</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncomeTaxDisclosureTextBlock" xlink:to="us-gaap_IncomeTaxDisclosureTextBlock_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued_lbl" xml:lang="en-US" id="id_12960622_2440356_1_1">Income Tax Examination, Penalties and Interest Accrued</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued_lbl" xml:lang="en-US" id="id_12960622_2440356_2_1">Company's accrued liability for interest and penalties related to income tax liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued" xlink:to="us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:label="us-gaap_IncomeTaxExpenseBenefit"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_12960622_2440740_2_1">Income tax expense (benefit)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_IncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_12960622_2440740_6_1">Income tax provision, Total</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability_lbl" xml:lang="en-US" id="id_12960622_2440358_2_1">Income tax benefit resulting from the reduction of deferred tax liabilities</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncreaseDecreaseInDeferredLiabilities_lbl" xml:lang="en-US" id="id_12960622_2440774_1_1">Increase (Decrease) in Deferred Liabilities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncreaseDecreaseInDeferredLiabilities_lbl" xml:lang="en-US" id="id_12960622_2440774_2_1">Increase (decrease) in net deferred tax liability</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncreaseDecreaseInDeferredLiabilities" xlink:to="us-gaap_IncreaseDecreaseInDeferredLiabilities_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:label="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract_lbl" xml:lang="en-US" id="id_12960622_2440238_1_1">Increase (Decrease) in Operating Capital [Abstract]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncreaseDecreaseInOtherNoncurrentAssets_lbl" xml:lang="en-US" id="id_12960622_2440431_1_1">Increase (Decrease) in Other Noncurrent Assets</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_IncreaseDecreaseInOtherOperatingLiabilities" xlink:label="us-gaap_IncreaseDecreaseInOtherOperatingLiabilities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncreaseDecreaseInOtherOperatingLiabilities_lbl" xml:lang="en-US" id="id_12960622_2440674_1_1">Increase (Decrease) in Other Operating Liabilities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncreaseDecreaseInOtherOperatingLiabilities_lbl" xml:lang="en-US" id="id_12960622_2440674_2_1">Other liabilities</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets" xlink:label="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets_lbl" xml:lang="en-US" id="id_12960622_2440814_1_1">Increase (Decrease) in Prepaid Expense and Other Assets</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets_lbl" xml:lang="en-US" id="id_12960622_2440814_14_1">Prepaid expenses and other current assets</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements" xlink:label="us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements_lbl" xml:lang="en-US" id="id_12960622_2440706_1_1">Incremental Common Shares Attributable to Dilutive Effect of Share-based Payment Arrangements</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_InsuranceSettlementsReceivable" xlink:label="us-gaap_InsuranceSettlementsReceivable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InsuranceSettlementsReceivable_lbl" xml:lang="en-US" id="id_12960622_2440929_1_1">Insurance Settlements Receivable</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InsuranceSettlementsReceivable_lbl" xml:lang="en-US" id="id_12960622_2440929_2_1">Insurance receivables</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InsuranceSettlementsReceivable" xlink:to="us-gaap_InsuranceSettlementsReceivable_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_InterestAndPenaltiesMember" xlink:label="md_InterestAndPenaltiesMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_InterestAndPenaltiesMember_lbl" xml:lang="en-US" id="id_12960622_2748577_3_1">Interest and penalties.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_InterestAndPenaltiesMember_lbl" xml:lang="en-US" id="id_12960622_2748577_1_1">Interest And Penalties [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_InterestAndPenaltiesMember_lbl" xml:lang="en-US" id="id_12960622_2748577_2_1">Interest and Penalties [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_InterestAndPenaltiesMember" xlink:to="md_InterestAndPenaltiesMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_InterestExpense" xlink:label="us-gaap_InterestExpense"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InterestExpense_lbl" xml:lang="en-US" id="id_12960622_2440889_1_1">Interest Expense</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_InterestExpense_lbl" xml:lang="en-US" id="id_12960622_2440889_14_1">Interest expense</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InterestExpense" xlink:to="us-gaap_InterestExpense_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_InterestPaidNet" xlink:label="us-gaap_InterestPaidNet"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InterestPaidNet_lbl" xml:lang="en-US" id="id_12960622_2441447_1_1">Interest Paid, Net</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InterestPaidNet_lbl" xml:lang="en-US" id="id_12960622_2441447_2_1">Interest</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InterestPaidNet" xlink:to="us-gaap_InterestPaidNet_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_InterestPayableCurrent" xlink:label="us-gaap_InterestPayableCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InterestPayableCurrent_lbl" xml:lang="en-US" id="id_12960622_2441448_1_1">Interest Payable, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InterestPayableCurrent_lbl" xml:lang="en-US" id="id_12960622_2441448_2_1">Accrued interest</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InterestPayableCurrent" xlink:to="us-gaap_InterestPayableCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_InvestmentIncomeNet" xlink:label="us-gaap_InvestmentIncomeNet"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InvestmentIncomeNet_lbl" xml:lang="en-US" id="id_12960622_2441306_1_1">Investment Income, Net</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InvestmentIncomeNet_lbl" xml:lang="en-US" id="id_12960622_2441306_2_1">Investment and other income</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InvestmentIncomeNet" xlink:to="us-gaap_InvestmentIncomeNet_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_InvestmentPolicyTextBlock" xlink:label="us-gaap_InvestmentPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InvestmentPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2441679_1_1">Investment, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InvestmentPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2441679_2_1">Investments</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InvestmentPolicyTextBlock" xlink:to="us-gaap_InvestmentPolicyTextBlock_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2441547_1_1">Investments Classified by Contractual Maturity Date [Table Text Block]</label>
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    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock" xlink:to="us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:label="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract_lbl" xml:lang="en-US" id="id_12960622_2441101_1_1">Investments, Debt and Equity Securities [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract_lbl" xml:lang="en-US" id="id_12960622_2441101_2_1">Investments, Debt and Equity Securities [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock" xlink:label="us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2441115_2_1">Investments</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="invest_InvestmentsScheduleAbstract_lbl" xml:lang="en-US" id="id_12960622_2441335_1_1">Investments Schedule [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="invest_InvestmentsScheduleAbstract_lbl" xml:lang="en-US" id="id_12960622_2441335_2_1">Investments Schedule [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="invest_InvestmentsScheduleAbstract" xlink:to="invest_InvestmentsScheduleAbstract_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InvestmentTypeAxis_lbl" xml:lang="en-US" id="id_12960622_2441568_1_1">Investment Type [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InvestmentTypeAxis_lbl" xml:lang="en-US" id="id_12960622_2441568_2_1">Investment Type [Axis]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InvestmentTypeCategorizationMember_lbl" xml:lang="en-US" id="id_12960622_2441127_1_1">Investments [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InvestmentTypeCategorizationMember_lbl" xml:lang="en-US" id="id_12960622_2441127_2_1">Investments [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InvestmentTypeCategorizationMember" xlink:to="us-gaap_InvestmentTypeCategorizationMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_Land" xlink:label="us-gaap_Land"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_Land_lbl" xml:lang="en-US" id="id_12960622_2441815_1_1">Land</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_Land_lbl" xml:lang="en-US" id="id_12960622_2441815_2_1">Land</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LatestTaxYearMember_lbl" xml:lang="en-US" id="id_12960622_2441819_1_1">Latest Tax Year [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LatestTaxYearMember_lbl" xml:lang="en-US" id="id_12960622_2441819_2_1">Latest Tax Year [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LatestTaxYearMember" xlink:to="us-gaap_LatestTaxYearMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LeaseAndRentalExpense" xlink:label="us-gaap_LeaseAndRentalExpense"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LeaseAndRentalExpense_lbl" xml:lang="en-US" id="id_12960622_2442260_1_1">Operating Leases, Rent Expense</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LeaseAndRentalExpense_lbl" xml:lang="en-US" id="id_12960622_2442260_2_1">Rent expense</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LeaseAndRentalExpense" xlink:to="us-gaap_LeaseAndRentalExpense_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LetterOfCreditMember_lbl" xml:lang="en-US" id="id_12960622_2441877_1_1">Letter of Credit [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LetterOfCreditMember_lbl" xml:lang="en-US" id="id_12960622_2441877_2_1">Letters of Credit [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LetterOfCreditMember" xlink:to="us-gaap_LetterOfCreditMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LettersOfCreditOutstandingAmount" xlink:label="us-gaap_LettersOfCreditOutstandingAmount"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LettersOfCreditOutstandingAmount_lbl" xml:lang="en-US" id="id_12960622_2441878_1_1">Letters of Credit Outstanding, Amount</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LettersOfCreditOutstandingAmount_lbl" xml:lang="en-US" id="id_12960622_2441878_2_1">Letters of credit outstanding amount</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LettersOfCreditOutstandingAmount" xlink:to="us-gaap_LettersOfCreditOutstandingAmount_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_Liabilities" xlink:label="us-gaap_Liabilities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_Liabilities_lbl" xml:lang="en-US" id="id_12960622_2442110_1_1">Liabilities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_Liabilities_lbl" xml:lang="en-US" id="id_12960622_2442110_6_1">Total liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_Liabilities" xlink:to="us-gaap_Liabilities_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LiabilitiesAndStockholdersEquity" xlink:label="us-gaap_LiabilitiesAndStockholdersEquity"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LiabilitiesAndStockholdersEquity_lbl" xml:lang="en-US" id="id_12960622_2442111_1_1">Liabilities and Equity</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_LiabilitiesAndStockholdersEquity_lbl" xml:lang="en-US" id="id_12960622_2442111_6_1">Total liabilities and shareholders' equity</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LiabilitiesAndStockholdersEquity" xlink:to="us-gaap_LiabilitiesAndStockholdersEquity_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:label="us-gaap_LiabilitiesAndStockholdersEquityAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LiabilitiesAndStockholdersEquityAbstract_lbl" xml:lang="en-US" id="id_12960622_2441888_1_1">Liabilities and Equity [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LiabilitiesAndStockholdersEquityAbstract_lbl" xml:lang="en-US" id="id_12960622_2441888_2_1">LIABILITIES &amp; SHAREHOLDERS' EQUITY</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_LiabilitiesAndStockholdersEquityAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LiabilitiesCurrent" xlink:label="us-gaap_LiabilitiesCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LiabilitiesCurrent_lbl" xml:lang="en-US" id="id_12960622_2442451_1_1">Liabilities, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_LiabilitiesCurrent_lbl" xml:lang="en-US" id="id_12960622_2442451_6_1">Total current liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LiabilitiesCurrent" xlink:to="us-gaap_LiabilitiesCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LiabilitiesCurrentAbstract" xlink:label="us-gaap_LiabilitiesCurrentAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LiabilitiesCurrentAbstract_lbl" xml:lang="en-US" id="id_12960622_2442113_1_1">Liabilities, Current [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LiabilitiesCurrentAbstract_lbl" xml:lang="en-US" id="id_12960622_2442113_2_1">Current liabilities:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LiabilitiesCurrentAbstract" xlink:to="us-gaap_LiabilitiesCurrentAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LineOfCreditFacilityCommitmentFeePercentage" xlink:label="us-gaap_LineOfCreditFacilityCommitmentFeePercentage"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LineOfCreditFacilityCommitmentFeePercentage_lbl" xml:lang="en-US" id="id_12960622_2442436_1_1">Line of Credit Facility, Commitment Fee Percentage</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LineOfCreditFacilityCommitmentFeePercentage_lbl" xml:lang="en-US" id="id_12960622_2442436_2_1">Commitment fee percentage</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LineOfCreditFacilityCommitmentFeePercentage" xlink:to="us-gaap_LineOfCreditFacilityCommitmentFeePercentage_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LineOfCreditFacilityExpirationDate1" xlink:label="us-gaap_LineOfCreditFacilityExpirationDate1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LineOfCreditFacilityExpirationDate1_lbl" xml:lang="en-US" id="id_12960622_2442438_1_1">Line of Credit Facility, Expiration Date</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LineOfCreditFacilityExpirationDate1_lbl" xml:lang="en-US" id="id_12960622_2442438_2_1">Line of Credit facility, maturity date</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LineOfCreditFacilityExpirationDate1" xlink:to="us-gaap_LineOfCreditFacilityExpirationDate1_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity" xlink:label="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity_lbl" xml:lang="en-US" id="id_12960622_2442441_1_1">Line of Credit Facility, Maximum Borrowing Capacity</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity_lbl" xml:lang="en-US" id="id_12960622_2442441_2_1">Line of Credit facility, borrowing capacity</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity" xlink:to="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity" xlink:label="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity_lbl" xml:lang="en-US" id="id_12960622_2442540_1_1">Line of Credit Facility, Remaining Borrowing Capacity</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity_lbl" xml:lang="en-US" id="id_12960622_2442540_2_1">Line of Credit facility, available balance</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity" xlink:to="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LineOfCreditFacilityTable" xlink:label="us-gaap_LineOfCreditFacilityTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LineOfCreditFacilityTable_lbl" xml:lang="en-US" id="id_12960622_2442443_1_1">Line of Credit Facility [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LineOfCreditFacilityTable_lbl" xml:lang="en-US" id="id_12960622_2442443_2_1">Line of Credit Facility [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_LineOfCreditFacilityTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LoansNotesTradeAndOtherReceivablesDisclosureTextBlock" xlink:label="us-gaap_LoansNotesTradeAndOtherReceivablesDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LoansNotesTradeAndOtherReceivablesDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2442724_1_1">Loans, Notes, Trade and Other Receivables Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LoansNotesTradeAndOtherReceivablesDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2442724_2_1">Accounts Receivable and Net Revenue</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LoansNotesTradeAndOtherReceivablesDisclosureTextBlock" xlink:to="us-gaap_LoansNotesTradeAndOtherReceivablesDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LondonInterbankOfferedRateLIBORMember" xlink:label="us-gaap_LondonInterbankOfferedRateLIBORMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LondonInterbankOfferedRateLIBORMember_lbl" xml:lang="en-US" id="id_12960622_2443155_1_1">London Interbank Offered Rate (LIBOR) [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LondonInterbankOfferedRateLIBORMember_lbl" xml:lang="en-US" id="id_12960622_2443155_2_1">LIBOR [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LondonInterbankOfferedRateLIBORMember" xlink:to="us-gaap_LondonInterbankOfferedRateLIBORMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LongTermDebt" xlink:label="us-gaap_LongTermDebt"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LongTermDebt_lbl" xml:lang="en-US" id="id_12960622_2442628_1_1">Long-term Debt</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LongTermDebt_lbl" xml:lang="en-US" id="id_12960622_2442628_2_1">Long term debt</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LongTermDebt" xlink:to="us-gaap_LongTermDebt_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent" xlink:label="us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent_lbl" xml:lang="en-US" id="id_12960622_2442752_1_1">Long-term Debt and Capital Lease Obligations, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent_lbl" xml:lang="en-US" id="id_12960622_2442752_2_1">Current portion of long-term debt and capital lease obligations</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent" xlink:to="us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit" xlink:label="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit_lbl" xml:lang="en-US" id="id_12960622_2597939_3_1">Long term debt and capital lease obligations excluding long term line of credit.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit_lbl" xml:lang="en-US" id="id_12960622_2597939_1_1">Long Term Debt and Capital Lease Obligations Excluding Long Term Line of Credit</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit_lbl" xml:lang="en-US" id="id_12960622_2597939_2_1">Long-term debt and capital lease obligations, net</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit" xlink:to="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LongTermDebtCurrent" xlink:label="us-gaap_LongTermDebtCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LongTermDebtCurrent_lbl" xml:lang="en-US" id="id_12960622_2442635_1_1">Long-term Debt, Current Maturities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_LongTermDebtCurrent_lbl" xml:lang="en-US" id="id_12960622_2442635_14_1">Less: Current portion</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LongTermDebtCurrent" xlink:to="us-gaap_LongTermDebtCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LongTermDebtNoncurrent" xlink:label="us-gaap_LongTermDebtNoncurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LongTermDebtNoncurrent_lbl" xml:lang="en-US" id="id_12960622_2443184_1_1">Long-term Debt, Excluding Current Maturities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LongTermDebtNoncurrent_lbl" xml:lang="en-US" id="id_12960622_2443184_2_1">Long-term portion</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LongTermDebtNoncurrent" xlink:to="us-gaap_LongTermDebtNoncurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_LongTermInvestmentsMaturityPeriod" xlink:label="md_LongTermInvestmentsMaturityPeriod"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_LongTermInvestmentsMaturityPeriod_lbl" xml:lang="en-US" id="id_12960622_2637500_3_1">Long term investments maturity period.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_LongTermInvestmentsMaturityPeriod_lbl" xml:lang="en-US" id="id_12960622_2637500_1_1">Long Term Investments Maturity Period</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_LongTermInvestmentsMaturityPeriod_lbl" xml:lang="en-US" id="id_12960622_2637500_2_1">Long-term investments maturity period, in years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_LongTermInvestmentsMaturityPeriod" xlink:to="md_LongTermInvestmentsMaturityPeriod_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_LongTermLineOfCredit" xlink:label="us-gaap_LongTermLineOfCredit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LongTermLineOfCredit_lbl" xml:lang="en-US" id="id_12960622_2443188_1_1">Long-term Line of Credit, Noncurrent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LongTermLineOfCredit_lbl" xml:lang="en-US" id="id_12960622_2443188_2_1">Line of credit</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LongTermLineOfCredit" xlink:to="us-gaap_LongTermLineOfCredit_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_MalpracticeLossContingencyAccrualUndiscounted" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscounted"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscounted_lbl" xml:lang="en-US" id="id_12960622_2443360_1_1">Malpractice Loss Contingency, Accrual, Undiscounted</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodEndLabel" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscounted_lbl" xml:lang="en-US" id="id_12960622_2443360_4_1">Balance at end of year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodStartLabel" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscounted_lbl" xml:lang="en-US" id="id_12960622_2443360_5_1">Balance at beginning of year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscounted_lbl" xml:lang="en-US" id="id_12960622_2443360_2_1">Total accrued professional liability</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MalpracticeLossContingencyAccrualUndiscounted" xlink:to="us-gaap_MalpracticeLossContingencyAccrualUndiscounted_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent_lbl" xml:lang="en-US" id="id_12960622_2443034_1_1">Malpractice Loss Contingency, Accrual, Undiscounted, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent_lbl" xml:lang="en-US" id="id_12960622_2443034_2_1">Accrued professional liabilities</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent_lbl" xml:lang="en-US" id="id_12960622_2443255_1_1">Malpractice Loss Contingency, Accrual, Undiscounted, Noncurrent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent_lbl" xml:lang="en-US" id="id_12960622_2443255_2_1">Long-term professional liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent" xlink:to="us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod_lbl" xml:lang="en-US" id="id_12960622_2442821_1_1">Malpractice Loss Contingency, Claims Incurred in Period</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod_lbl" xml:lang="en-US" id="id_12960622_2442821_14_1">Claim payments related to Current year</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod" xlink:to="us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods_lbl" xml:lang="en-US" id="id_12960622_2442822_1_1">Malpractice Loss Contingency, Claims Incurred in Prior Periods</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods_lbl" xml:lang="en-US" id="id_12960622_2442822_14_1">Claim payments related to Prior years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods" xlink:to="us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_MalpracticeLossContingencyClaimsIncurredNet" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredNet"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredNet_lbl" xml:lang="en-US" id="id_12960622_2443035_1_1">Malpractice Loss Contingency, Claims Incurred, Net</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedTotalLabel" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredNet_lbl" xml:lang="en-US" id="id_12960622_2443035_19_1">Total payments</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MalpracticeLossContingencyClaimsIncurredNet" xlink:to="us-gaap_MalpracticeLossContingencyClaimsIncurredNet_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_MalpracticeLossContingencyDisclosureTextBlock" xlink:label="us-gaap_MalpracticeLossContingencyDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MalpracticeLossContingencyDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2443037_1_1">Malpractice Loss Contingency Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_MalpracticeLossContingencyDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2443037_2_1">Accrued Professional Liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MalpracticeLossContingencyDisclosureTextBlock" xlink:to="us-gaap_MalpracticeLossContingencyDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_MalpracticeLossContingencyPeriodIncreaseDecrease" xlink:label="us-gaap_MalpracticeLossContingencyPeriodIncreaseDecrease"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MalpracticeLossContingencyPeriodIncreaseDecrease_lbl" xml:lang="en-US" id="id_12960622_2443039_1_1">Malpractice Loss Contingency, Period Increase (Decrease)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_MalpracticeLossContingencyPeriodIncreaseDecrease_lbl" xml:lang="en-US" id="id_12960622_2443039_2_1">Long-term professional liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MalpracticeLossContingencyPeriodIncreaseDecrease" xlink:to="us-gaap_MalpracticeLossContingencyPeriodIncreaseDecrease_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_MalpracticeLossContingencyProvisionForLosses" xlink:label="md_MalpracticeLossContingencyProvisionForLosses"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_MalpracticeLossContingencyProvisionForLosses_lbl" xml:lang="en-US" id="id_12960622_2568878_3_1">Malpractice loss contingency provision for losses.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_MalpracticeLossContingencyProvisionForLosses_lbl" xml:lang="en-US" id="id_12960622_2568878_1_1">Malpractice Loss Contingency Provision For Losses</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="md_MalpracticeLossContingencyProvisionForLosses_lbl" xml:lang="en-US" id="id_12960622_2568878_6_1">Total provision for losses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_MalpracticeLossContingencyProvisionForLosses" xlink:to="md_MalpracticeLossContingencyProvisionForLosses_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_ManagementServicesMember" xlink:label="md_ManagementServicesMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ManagementServicesMember_lbl" xml:lang="en-US" id="id_12960622_2680097_3_1">Management services.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ManagementServicesMember_lbl" xml:lang="en-US" id="id_12960622_2680097_1_1">Management Services [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ManagementServicesMember_lbl" xml:lang="en-US" id="id_12960622_2680097_2_1">Management Services [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ManagementServicesMember" xlink:to="md_ManagementServicesMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_MaternalFetalMedicineMember" xlink:label="md_MaternalFetalMedicineMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_MaternalFetalMedicineMember_lbl" xml:lang="en-US" id="id_12960622_2695081_3_1">Maternal fetal medicine.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_MaternalFetalMedicineMember_lbl" xml:lang="en-US" id="id_12960622_2695081_1_1">Maternal Fetal Medicine [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_MaternalFetalMedicineMember_lbl" xml:lang="en-US" id="id_12960622_2695081_2_1">Maternal-Fetal Medicine [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_MaternalFetalMedicineMember" xlink:to="md_MaternalFetalMedicineMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_MaximumMember" xlink:label="us-gaap_MaximumMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MaximumMember_lbl" xml:lang="en-US" id="id_12960622_2442860_1_1">Maximum [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_MaximumMember_lbl" xml:lang="en-US" id="id_12960622_2442860_2_1">Maximum [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MaximumMember" xlink:to="us-gaap_MaximumMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember" xlink:label="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember_lbl" xml:lang="en-US" id="id_12960622_2694770_3_1">Medical and other equipment held under capital lease.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember_lbl" xml:lang="en-US" id="id_12960622_2694770_1_1">Medical And Other Equipment Held Under Capital Lease [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember_lbl" xml:lang="en-US" id="id_12960622_2694770_2_1">Medical and Other Equipment Held under Capital Lease [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember" xlink:to="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_MinimumMember" xlink:label="us-gaap_MinimumMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MinimumMember_lbl" xml:lang="en-US" id="id_12960622_2443301_1_1">Minimum [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_MinimumMember_lbl" xml:lang="en-US" id="id_12960622_2443301_2_1">Minimum [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MinimumMember" xlink:to="us-gaap_MinimumMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_MoneyMarketFundsAtFairValue" xlink:label="md_MoneyMarketFundsAtFairValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_MoneyMarketFundsAtFairValue_lbl" xml:lang="en-US" id="id_12960622_2499903_3_1">Money market funds at fair value.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_MoneyMarketFundsAtFairValue_lbl" xml:lang="en-US" id="id_12960622_2499903_1_1">Money Market Funds At Fair Value</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_MoneyMarketFundsAtFairValue_lbl" xml:lang="en-US" id="id_12960622_2499903_2_1">Money market funds fair value</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_MoneyMarketFundsAtFairValue" xlink:to="md_MoneyMarketFundsAtFairValue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_NatureOfOperations" xlink:label="us-gaap_NatureOfOperations"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NatureOfOperations_lbl" xml:lang="en-US" id="id_12960622_2443490_1_1">Nature of Operations [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_NatureOfOperations_lbl" xml:lang="en-US" id="id_12960622_2443490_2_1">General</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NatureOfOperations" xlink:to="us-gaap_NatureOfOperations_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_NeonatologyAndOtherPediatricSubspecialtiesMember" xlink:label="md_NeonatologyAndOtherPediatricSubspecialtiesMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NeonatologyAndOtherPediatricSubspecialtiesMember_lbl" xml:lang="en-US" id="id_12960622_2695079_3_1">Neonatology and other pediatric subspecialties.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NeonatologyAndOtherPediatricSubspecialtiesMember_lbl" xml:lang="en-US" id="id_12960622_2695079_1_1">Neonatology And Other Pediatric Subspecialties [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NeonatologyAndOtherPediatricSubspecialtiesMember_lbl" xml:lang="en-US" id="id_12960622_2695079_2_1">Neonatology and Other Pediatric Subspecialties [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NeonatologyAndOtherPediatricSubspecialtiesMember" xlink:to="md_NeonatologyAndOtherPediatricSubspecialtiesMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperations" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperations"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperations_lbl" xml:lang="en-US" id="id_12960622_2444055_1_1">Net Cash Provided by (Used in) Financing Activities, Continuing Operations</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperations_lbl" xml:lang="en-US" id="id_12960622_2444055_6_1">Net cash provided from financing activities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperations" xlink:to="us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperations_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperationsAbstract" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperationsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperationsAbstract_lbl" xml:lang="en-US" id="id_12960622_2443641_1_1">Net Cash Provided by (Used in) Financing Activities, Continuing Operations [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperationsAbstract_lbl" xml:lang="en-US" id="id_12960622_2443641_2_1">Cash flows from financing activities:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperationsAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperationsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperations" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperations"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperations_lbl" xml:lang="en-US" id="id_12960622_2443502_1_1">Net Cash Provided by (Used in) Investing Activities, Continuing Operations</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperations_lbl" xml:lang="en-US" id="id_12960622_2443502_6_1">Net cash used in investing activities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperations" xlink:to="us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperations_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperationsAbstract" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperationsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperationsAbstract_lbl" xml:lang="en-US" id="id_12960622_2443643_1_1">Net Cash Provided by (Used in) Investing Activities, Continuing Operations [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperationsAbstract_lbl" xml:lang="en-US" id="id_12960622_2443643_2_1">Cash flows from investing activities:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperationsAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperationsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_NetCashProvidedByUsedInOperatingActivitiesContinuingOperations" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivitiesContinuingOperations"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivitiesContinuingOperations_lbl" xml:lang="en-US" id="id_12960622_2443503_1_1">Net Cash Provided by (Used in) Operating Activities, Continuing Operations</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivitiesContinuingOperations_lbl" xml:lang="en-US" id="id_12960622_2443503_6_1">Net cash provided from operating activities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivitiesContinuingOperations" xlink:to="us-gaap_NetCashProvidedByUsedInOperatingActivitiesContinuingOperations_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_NetCashProvidedByUsedInOperatingActivitiesContinuingOperationsAbstract" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivitiesContinuingOperationsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivitiesContinuingOperationsAbstract_lbl" xml:lang="en-US" id="id_12960622_2443504_1_1">Net Cash Provided by (Used in) Operating Activities, Continuing Operations [Abstract]</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_NetIncomeLoss" xlink:label="us-gaap_NetIncomeLoss"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetIncomeLoss_lbl" xml:lang="en-US" id="id_12960622_2444061_1_1">Net Income (Loss) Attributable to Parent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_NetIncomeLoss_lbl" xml:lang="en-US" id="id_12960622_2444061_2_1">Net income attributable to MEDNAX, Inc.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_NetIncomeLoss_lbl" xml:lang="en-US" id="id_12960622_2444061_6_1">Net income attributable to MEDNAX, Inc.</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NetIncomeLoss" xlink:to="us-gaap_NetIncomeLoss_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" xlink:label="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest_lbl" xml:lang="en-US" id="id_12960622_2444062_1_1">Net Income (Loss) Attributable to Noncontrolling Interest</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest_lbl" xml:lang="en-US" id="id_12960622_2444062_14_1">Net loss attributable to noncontrolling interests</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" xlink:to="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_NetOperatingLossCarryForwardsExpirationDate" xlink:label="md_NetOperatingLossCarryForwardsExpirationDate"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NetOperatingLossCarryForwardsExpirationDate_lbl" xml:lang="en-US" id="id_12960622_2621371_3_1">Net operating loss carry forwards expiration date.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NetOperatingLossCarryForwardsExpirationDate_lbl" xml:lang="en-US" id="id_12960622_2621371_1_1">Net Operating Loss Carry Forwards Expiration Date</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NetOperatingLossCarryForwardsExpirationDate_lbl" xml:lang="en-US" id="id_12960622_2621371_2_1">Expiration period of operating loss carryforwards</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NetOperatingLossCarryForwardsExpirationDate" xlink:to="md_NetOperatingLossCarryForwardsExpirationDate_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock" xlink:label="us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2444191_1_1">New Accounting Pronouncements, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2444191_2_1">New Accounting Pronouncements</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock" xlink:to="us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember" xlink:label="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember_lbl" xml:lang="en-US" id="id_12960622_2676333_3_1">Nineteen Ninety Six Non Qualified Employee Stock Purchase Plan And Two Thousand Fifteen Non Qualified Stock Purchase Plan [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember_lbl" xml:lang="en-US" id="id_12960622_2676333_1_1">Nineteen Ninety Six Non Qualified Employee Stock Purchase Plan And Two Thousand Fifteen Non Qualified Stock Purchase Plan [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember_lbl" xml:lang="en-US" id="id_12960622_2676333_2_1">1996 Non-Qualified Employee Stock Purchase Plan and 2015 Non-Qualified Stock Purchase Plan [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember" xlink:to="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember" xlink:label="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember_lbl" xml:lang="en-US" id="id_12960622_2751894_3_1">1996 non-qualified employee stock purchase plan.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember_lbl" xml:lang="en-US" id="id_12960622_2751894_1_1">Nineteen Ninety Six Non Qualified Employee Stock Purchase Plan [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember_lbl" xml:lang="en-US" id="id_12960622_2751894_2_1">1996 Non-Qualified Employee Stock Purchase Plan [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember" xlink:to="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_NoncontrollingInterestMember" xlink:label="us-gaap_NoncontrollingInterestMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NoncontrollingInterestMember_lbl" xml:lang="en-US" id="id_12960622_2444105_1_1">Noncontrolling Interest [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_NoncontrollingInterestMember_lbl" xml:lang="en-US" id="id_12960622_2444105_2_1">Noncontrolling Interests [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NoncontrollingInterestMember" xlink:to="us-gaap_NoncontrollingInterestMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_NonoperatingIncomeExpense" xlink:label="us-gaap_NonoperatingIncomeExpense"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NonoperatingIncomeExpense_lbl" xml:lang="en-US" id="id_12960622_2444227_1_1">Nonoperating Income (Expense)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_NonoperatingIncomeExpense_lbl" xml:lang="en-US" id="id_12960622_2444227_2_1">Total non-operating expenses</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_NonoperatingIncomeExpense_lbl" xml:lang="en-US" id="id_12960622_2444227_6_1">Total non-operating expenses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NonoperatingIncomeExpense" xlink:to="us-gaap_NonoperatingIncomeExpense_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_NotesPayableFairValueDisclosure" xlink:label="us-gaap_NotesPayableFairValueDisclosure"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NotesPayableFairValueDisclosure_lbl" xml:lang="en-US" id="id_12960622_2444240_1_1">Notes Payable, Fair Value Disclosure</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_NotesPayableFairValueDisclosure_lbl" xml:lang="en-US" id="id_12960622_2444240_2_1">Estimated fair value of notes</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NotesPayableFairValueDisclosure" xlink:to="us-gaap_NotesPayableFairValueDisclosure_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_NumberOfAnesthesiologyPracticesAcquired" xlink:label="md_NumberOfAnesthesiologyPracticesAcquired"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NumberOfAnesthesiologyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2622500_3_1">Number of anesthesiology practices acquired.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NumberOfAnesthesiologyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2622500_1_1">Number Of Anesthesiology Practices Acquired</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NumberOfAnesthesiologyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2622500_2_1">Number of anesthesiology practices acquired</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NumberOfAnesthesiologyPracticesAcquired" xlink:to="md_NumberOfAnesthesiologyPracticesAcquired_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_NumberOfBusinessesAcquired" xlink:label="us-gaap_NumberOfBusinessesAcquired"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NumberOfBusinessesAcquired_lbl" xml:lang="en-US" id="id_12960622_2444248_1_1">Number of Businesses Acquired</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_NumberOfBusinessesAcquired_lbl" xml:lang="en-US" id="id_12960622_2444248_2_1">Number of business acquired</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NumberOfBusinessesAcquired" xlink:to="us-gaap_NumberOfBusinessesAcquired_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_NumberOfMaternalfetalMedicinePracticesAcquired" xlink:label="md_NumberOfMaternalfetalMedicinePracticesAcquired"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NumberOfMaternalfetalMedicinePracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2626397_3_1">Number of maternal-fetal medicine practices acquired.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NumberOfMaternalfetalMedicinePracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2626397_1_1">Number Of Maternal-fetal Medicine Practices Acquired</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NumberOfMaternalfetalMedicinePracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2626397_2_1">Number of maternal-fetal medicine practices acquired</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NumberOfMaternalfetalMedicinePracticesAcquired" xlink:to="md_NumberOfMaternalfetalMedicinePracticesAcquired_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_NumberOfNeonatologyPracticesAcquired" xlink:label="md_NumberOfNeonatologyPracticesAcquired"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NumberOfNeonatologyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2627737_3_1">Number of neonatology practices acquired.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NumberOfNeonatologyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2627737_1_1">Number Of Neonatology Practices Acquired</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NumberOfNeonatologyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2627737_2_1">Number of neonatology practices acquired</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NumberOfNeonatologyPracticesAcquired" xlink:to="md_NumberOfNeonatologyPracticesAcquired_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_NumberOfPatientEngagementSoftwareCompanyAcquired" xlink:label="md_NumberOfPatientEngagementSoftwareCompanyAcquired"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NumberOfPatientEngagementSoftwareCompanyAcquired_lbl" xml:lang="en-US" id="id_12960622_2626492_3_1">Number of patient engagement software company acquired.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NumberOfPatientEngagementSoftwareCompanyAcquired_lbl" xml:lang="en-US" id="id_12960622_2626492_1_1">Number Of Patient Engagement Software Company Acquired</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NumberOfPatientEngagementSoftwareCompanyAcquired_lbl" xml:lang="en-US" id="id_12960622_2626492_2_1">Number of patient engagement software company acquired</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NumberOfPatientEngagementSoftwareCompanyAcquired" xlink:to="md_NumberOfPatientEngagementSoftwareCompanyAcquired_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_NumberOfPediatricCardiologyPracticesAcquired" xlink:label="md_NumberOfPediatricCardiologyPracticesAcquired"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NumberOfPediatricCardiologyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2626398_3_1">Number of pediatric cardiology practices acquired.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NumberOfPediatricCardiologyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2626398_1_1">Number Of Pediatric Cardiology Practices Acquired</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NumberOfPediatricCardiologyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2626398_2_1">Number of pediatric cardiology practices acquired</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NumberOfPediatricCardiologyPracticesAcquired" xlink:to="md_NumberOfPediatricCardiologyPracticesAcquired_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_NumberOfPediatricMultiSpecialtyPracticesAcquired" xlink:label="md_NumberOfPediatricMultiSpecialtyPracticesAcquired"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NumberOfPediatricMultiSpecialtyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2895884_3_1">Number of pediatric multi-specialty practices acquired.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NumberOfPediatricMultiSpecialtyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2895884_1_1">Number Of Pediatric Multi Specialty Practices Acquired</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NumberOfPediatricMultiSpecialtyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2895884_2_1">Number of pediatric multi-specialty practice acquired</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NumberOfPediatricMultiSpecialtyPracticesAcquired" xlink:to="md_NumberOfPediatricMultiSpecialtyPracticesAcquired_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_NumberOfPediatricSubspecialtyPracticesAcquired" xlink:label="md_NumberOfPediatricSubspecialtyPracticesAcquired"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NumberOfPediatricSubspecialtyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2626493_3_1">Number of other pediatric subspecialty practices acquired.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NumberOfPediatricSubspecialtyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2626493_1_1">Number Of Pediatric Subspecialty Practices Acquired</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NumberOfPediatricSubspecialtyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2626493_2_1">Number of other pediatric subspecialty practices acquired</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NumberOfPediatricSubspecialtyPracticesAcquired" xlink:to="md_NumberOfPediatricSubspecialtyPracticesAcquired_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_NumberOfPhysicianGroupPracticesAcquired" xlink:label="md_NumberOfPhysicianGroupPracticesAcquired"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NumberOfPhysicianGroupPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2622890_3_1">Number of physician group practices acquired.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NumberOfPhysicianGroupPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2622890_1_1">Number Of Physician Group Practices Acquired</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NumberOfPhysicianGroupPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2622890_2_1">Number of physician group practices acquired</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NumberOfPhysicianGroupPracticesAcquired" xlink:to="md_NumberOfPhysicianGroupPracticesAcquired_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_NumberOfRadiologyPracticesAcquired" xlink:label="md_NumberOfRadiologyPracticesAcquired"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NumberOfRadiologyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2626638_3_1">Number of radiology practices acquired.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NumberOfRadiologyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2626638_1_1">Number Of Radiology Practices Acquired</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NumberOfRadiologyPracticesAcquired_lbl" xml:lang="en-US" id="id_12960622_2626638_2_1">Number of radiology practices acquired</label>
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    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_NumberOfThirdpartyReceivablesCompaniesAcquired" xlink:label="md_NumberOfThirdpartyReceivablesCompaniesAcquired"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NumberOfThirdpartyReceivablesCompaniesAcquired_lbl" xml:lang="en-US" id="id_12960622_2626399_3_1">Number of third-party receivables companies acquired.</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OpenTaxYear" xlink:label="us-gaap_OpenTaxYear"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OpenTaxYear_lbl" xml:lang="en-US" id="id_12960622_2443961_1_1">Open Tax Year</label>
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    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OpenTaxYear" xlink:to="us-gaap_OpenTaxYear_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OperatingExpenses" xlink:label="us-gaap_OperatingExpenses"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingExpenses_lbl" xml:lang="en-US" id="id_12960622_2443964_1_1">Operating Expenses</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingExpenses_lbl" xml:lang="en-US" id="id_12960622_2443964_2_1">Total operating expenses</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_OperatingExpenses_lbl" xml:lang="en-US" id="id_12960622_2443964_6_1">Total operating expenses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingExpenses" xlink:to="us-gaap_OperatingExpenses_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OperatingExpensesAbstract" xlink:label="us-gaap_OperatingExpensesAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingExpensesAbstract_lbl" xml:lang="en-US" id="id_12960622_2444430_1_1">Operating Expenses [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingExpensesAbstract_lbl" xml:lang="en-US" id="id_12960622_2444430_2_1">Operating expenses:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingExpensesAbstract" xlink:to="us-gaap_OperatingExpensesAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OperatingIncomeLoss" xlink:label="us-gaap_OperatingIncomeLoss"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingIncomeLoss_lbl" xml:lang="en-US" id="id_12960622_2444189_1_1">Operating Income (Loss)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingIncomeLoss_lbl" xml:lang="en-US" id="id_12960622_2444189_2_1">Income from operations</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_OperatingIncomeLoss_lbl" xml:lang="en-US" id="id_12960622_2444189_6_1">Income from operations</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingIncomeLoss" xlink:to="us-gaap_OperatingIncomeLoss_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDue" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDue_lbl" xml:lang="en-US" id="id_12960622_2444621_1_1">Operating Leases, Future Minimum Payments Due</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDue_lbl" xml:lang="en-US" id="id_12960622_2444621_6_1">Total</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDue" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent_lbl" xml:lang="en-US" id="id_12960622_2444839_1_1">Operating Leases, Future Minimum Payments Due, Next Twelve Months</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent_lbl" xml:lang="en-US" id="id_12960622_2444839_2_1">2018</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears_lbl" xml:lang="en-US" id="id_12960622_2444840_1_1">Operating Leases, Future Minimum Payments, Due in Five Years</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears_lbl" xml:lang="en-US" id="id_12960622_2444840_2_1">2022</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears_lbl" xml:lang="en-US" id="id_12960622_2444842_1_1">Operating Leases, Future Minimum Payments, Due in Four Years</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears_lbl" xml:lang="en-US" id="id_12960622_2444842_2_1">2021</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears_lbl" xml:lang="en-US" id="id_12960622_2444444_1_1">Operating Leases, Future Minimum Payments, Due in Three Years</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears_lbl" xml:lang="en-US" id="id_12960622_2444444_2_1">2020</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears_lbl" xml:lang="en-US" id="id_12960622_2444624_1_1">Operating Leases, Future Minimum Payments, Due in Two Years</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears_lbl" xml:lang="en-US" id="id_12960622_2444624_2_1">2019</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter_lbl" xml:lang="en-US" id="id_12960622_2444295_1_1">Operating Leases, Future Minimum Payments, Due Thereafter</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter_lbl" xml:lang="en-US" id="id_12960622_2444295_2_1">Thereafter</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OperatingLossCarryforwards" xlink:label="us-gaap_OperatingLossCarryforwards"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLossCarryforwards_lbl" xml:lang="en-US" id="id_12960622_2444632_1_1">Operating Loss Carryforwards</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingLossCarryforwards_lbl" xml:lang="en-US" id="id_12960622_2444632_2_1">Net operating loss carryforwards for federal and state tax</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLossCarryforwards" xlink:to="us-gaap_OperatingLossCarryforwards_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:label="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract_lbl" xml:lang="en-US" id="id_12960622_2444466_1_1">Organization, Consolidation and Presentation of Financial Statements [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract_lbl" xml:lang="en-US" id="id_12960622_2444466_2_1">Organization, Consolidation and Presentation of Financial Statements [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OtherAccruedLiabilitiesCurrent" xlink:label="us-gaap_OtherAccruedLiabilitiesCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OtherAccruedLiabilitiesCurrent_lbl" xml:lang="en-US" id="id_12960622_2444315_1_1">Other Accrued Liabilities, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OtherAccruedLiabilitiesCurrent_lbl" xml:lang="en-US" id="id_12960622_2444315_2_1">Other accrued expenses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OtherAccruedLiabilitiesCurrent" xlink:to="us-gaap_OtherAccruedLiabilitiesCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OtherAssetsCurrent" xlink:label="us-gaap_OtherAssetsCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OtherAssetsCurrent_lbl" xml:lang="en-US" id="id_12960622_2444319_1_1">Other Assets, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OtherAssetsCurrent_lbl" xml:lang="en-US" id="id_12960622_2444319_2_1">Other assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OtherAssetsCurrent" xlink:to="us-gaap_OtherAssetsCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OtherAssetsNoncurrent" xlink:label="us-gaap_OtherAssetsNoncurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OtherAssetsNoncurrent_lbl" xml:lang="en-US" id="id_12960622_2444650_1_1">Other Assets, Noncurrent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OtherAssetsNoncurrent_lbl" xml:lang="en-US" id="id_12960622_2444650_2_1">Other assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OtherAssetsNoncurrent" xlink:to="us-gaap_OtherAssetsNoncurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OtherLiabilitiesNoncurrent" xlink:label="us-gaap_OtherLiabilitiesNoncurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OtherLiabilitiesNoncurrent_lbl" xml:lang="en-US" id="id_12960622_2444753_1_1">Other Liabilities, Noncurrent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OtherLiabilitiesNoncurrent_lbl" xml:lang="en-US" id="id_12960622_2444753_2_1">Other liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OtherLiabilitiesNoncurrent" xlink:to="us-gaap_OtherLiabilitiesNoncurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OtherNoncashIncomeExpense" xlink:label="us-gaap_OtherNoncashIncomeExpense"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OtherNoncashIncomeExpense_lbl" xml:lang="en-US" id="id_12960622_2445064_1_1">Other Noncash Income (Expense)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_OtherNoncashIncomeExpense_lbl" xml:lang="en-US" id="id_12960622_2445064_14_1">Other</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OtherNoncashIncomeExpense" xlink:to="us-gaap_OtherNoncashIncomeExpense_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OtherOwnershipInterestsByNameAxis" xlink:label="us-gaap_OtherOwnershipInterestsByNameAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OtherOwnershipInterestsByNameAxis_lbl" xml:lang="en-US" id="id_12960622_2444764_1_1">Other Ownership Interests Name [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OtherOwnershipInterestsByNameAxis_lbl" xml:lang="en-US" id="id_12960622_2444764_2_1">Other Ownership Interests Name [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OtherOwnershipInterestsByNameAxis" xlink:to="us-gaap_OtherOwnershipInterestsByNameAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_OtherOwnershipInterestsNameDomain" xlink:label="us-gaap_OtherOwnershipInterestsNameDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OtherOwnershipInterestsNameDomain_lbl" xml:lang="en-US" id="id_12960622_2445073_1_1">Other Ownership Interests, Name [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OtherOwnershipInterestsNameDomain_lbl" xml:lang="en-US" id="id_12960622_2445073_2_1">Other Ownership Interests, Name [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OtherOwnershipInterestsNameDomain" xlink:to="us-gaap_OtherOwnershipInterestsNameDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_PatentedAndOtherTechnologyMember" xlink:label="md_PatentedAndOtherTechnologyMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_PatentedAndOtherTechnologyMember_lbl" xml:lang="en-US" id="id_12960622_2695071_3_1">Patented and other technology.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_PatentedAndOtherTechnologyMember_lbl" xml:lang="en-US" id="id_12960622_2695071_1_1">Patented And Other Technology [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_PatentedAndOtherTechnologyMember_lbl" xml:lang="en-US" id="id_12960622_2695071_2_1">Patented and Other Technology [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_PatentedAndOtherTechnologyMember" xlink:to="md_PatentedAndOtherTechnologyMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PayablesAndAccrualsAbstract" xlink:label="us-gaap_PayablesAndAccrualsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PayablesAndAccrualsAbstract_lbl" xml:lang="en-US" id="id_12960622_2445297_1_1">Payables and Accruals [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PayablesAndAccrualsAbstract_lbl" xml:lang="en-US" id="id_12960622_2445297_2_1">Payables and Accruals [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_PayablesAndAccrualsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PaymentForContingentConsiderationLiabilityFinancingActivities" xlink:label="us-gaap_PaymentForContingentConsiderationLiabilityFinancingActivities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PaymentForContingentConsiderationLiabilityFinancingActivities_lbl" xml:lang="en-US" id="id_12960622_2445687_1_1">Payment for Contingent Consideration Liability, Financing Activities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_PaymentForContingentConsiderationLiabilityFinancingActivities_lbl" xml:lang="en-US" id="id_12960622_2445687_14_1">Payments of contingent consideration liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PaymentForContingentConsiderationLiabilityFinancingActivities" xlink:to="us-gaap_PaymentForContingentConsiderationLiabilityFinancingActivities_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PaymentForContingentConsiderationLiabilityOperatingActivities" xlink:label="us-gaap_PaymentForContingentConsiderationLiabilityOperatingActivities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PaymentForContingentConsiderationLiabilityOperatingActivities_lbl" xml:lang="en-US" id="id_12960622_2445688_1_1">Payment for Contingent Consideration Liability, Operating Activities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_PaymentForContingentConsiderationLiabilityOperatingActivities_lbl" xml:lang="en-US" id="id_12960622_2445688_14_1">Payments of contingent consideration liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PaymentForContingentConsiderationLiabilityOperatingActivities" xlink:to="us-gaap_PaymentForContingentConsiderationLiabilityOperatingActivities_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PaymentsForPreviousAcquisition" xlink:label="us-gaap_PaymentsForPreviousAcquisition"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PaymentsForPreviousAcquisition_lbl" xml:lang="en-US" id="id_12960622_2445162_1_1">Payments for Previous Acquisition</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PaymentsForPreviousAcquisition_lbl" xml:lang="en-US" id="id_12960622_2445162_2_1">Contingent consideration payments related to prior-period acquisitions</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PaymentsForPreviousAcquisition" xlink:to="us-gaap_PaymentsForPreviousAcquisition_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PaymentsForProceedsFromOtherInvestingActivities" xlink:label="us-gaap_PaymentsForProceedsFromOtherInvestingActivities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PaymentsForProceedsFromOtherInvestingActivities_lbl" xml:lang="en-US" id="id_12960622_2445718_1_1">Payments for (Proceeds from) Other Investing Activities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_PaymentsForProceedsFromOtherInvestingActivities_lbl" xml:lang="en-US" id="id_12960622_2445718_14_1">Other</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PaymentsForProceedsFromOtherInvestingActivities" xlink:to="us-gaap_PaymentsForProceedsFromOtherInvestingActivities_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PaymentsForRepurchaseOfCommonStock" xlink:label="us-gaap_PaymentsForRepurchaseOfCommonStock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PaymentsForRepurchaseOfCommonStock_lbl" xml:lang="en-US" id="id_12960622_2445519_1_1">Payments for Repurchase of Common Stock</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_PaymentsForRepurchaseOfCommonStock_lbl" xml:lang="en-US" id="id_12960622_2445519_14_1">Repurchases of common stock</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PaymentsForRepurchaseOfCommonStock" xlink:to="us-gaap_PaymentsForRepurchaseOfCommonStock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PaymentsOfFinancingCosts" xlink:label="us-gaap_PaymentsOfFinancingCosts"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PaymentsOfFinancingCosts_lbl" xml:lang="en-US" id="id_12960622_2445174_1_1">Payments of Financing Costs</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_PaymentsOfFinancingCosts_lbl" xml:lang="en-US" id="id_12960622_2445174_14_1">Payments for financing costs</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PaymentsOfFinancingCosts" xlink:to="us-gaap_PaymentsOfFinancingCosts_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PaymentsToAcquireBusinessesGross" xlink:label="us-gaap_PaymentsToAcquireBusinessesGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PaymentsToAcquireBusinessesGross_lbl" xml:lang="en-US" id="id_12960622_2445740_1_1">Payments to Acquire Businesses, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PaymentsToAcquireBusinessesGross_lbl" xml:lang="en-US" id="id_12960622_2445740_2_1">Cash payments to acquire businesses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PaymentsToAcquireBusinessesGross" xlink:to="us-gaap_PaymentsToAcquireBusinessesGross_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired" xlink:label="us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired_lbl" xml:lang="en-US" id="id_12960622_2445532_1_1">Payments to Acquire Businesses, Net of Cash Acquired</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired_lbl" xml:lang="en-US" id="id_12960622_2445532_14_1">Acquisition payments, net of cash acquired</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired" xlink:to="us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PaymentsToAcquireInvestments" xlink:label="us-gaap_PaymentsToAcquireInvestments"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PaymentsToAcquireInvestments_lbl" xml:lang="en-US" id="id_12960622_2445184_1_1">Payments to Acquire Investments</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_PaymentsToAcquireInvestments_lbl" xml:lang="en-US" id="id_12960622_2445184_14_1">Purchases of investments</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PaymentsToAcquireInvestments" xlink:to="us-gaap_PaymentsToAcquireInvestments_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PaymentsToAcquireOtherPropertyPlantAndEquipment" xlink:label="us-gaap_PaymentsToAcquireOtherPropertyPlantAndEquipment"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PaymentsToAcquireOtherPropertyPlantAndEquipment_lbl" xml:lang="en-US" id="id_12960622_2445198_1_1">Payments to Acquire Other Property, Plant, and Equipment</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_PaymentsToAcquireOtherPropertyPlantAndEquipment_lbl" xml:lang="en-US" id="id_12960622_2445198_14_1">Purchases of property and equipment</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PaymentsToAcquireOtherPropertyPlantAndEquipment" xlink:to="us-gaap_PaymentsToAcquireOtherPropertyPlantAndEquipment_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_PediatricCardiologyMember" xlink:label="md_PediatricCardiologyMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_PediatricCardiologyMember_lbl" xml:lang="en-US" id="id_12960622_2668897_3_1">Pediatric cardiology.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_PediatricCardiologyMember_lbl" xml:lang="en-US" id="id_12960622_2668897_1_1">Pediatric Cardiology [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_PediatricCardiologyMember_lbl" xml:lang="en-US" id="id_12960622_2668897_2_1">Pediatric Cardiology [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_PediatricCardiologyMember" xlink:to="md_PediatricCardiologyMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock" xlink:label="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2445765_1_1">Pension and Other Postretirement Benefits Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2445765_2_1">Retirement Plans</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock" xlink:to="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_PhysicianAndHospitalAgreementsMember" xlink:label="md_PhysicianAndHospitalAgreementsMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_PhysicianAndHospitalAgreementsMember_lbl" xml:lang="en-US" id="id_12960622_2701558_3_1">Physician And Hospital Agreements [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_PhysicianAndHospitalAgreementsMember_lbl" xml:lang="en-US" id="id_12960622_2701558_1_1">Physician And Hospital Agreements [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_PhysicianAndHospitalAgreementsMember_lbl" xml:lang="en-US" id="id_12960622_2701558_2_1">Physician And Hospital Agreements [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_PhysicianAndHospitalAgreementsMember" xlink:to="md_PhysicianAndHospitalAgreementsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_PhysicianGroupMember" xlink:label="md_PhysicianGroupMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_PhysicianGroupMember_lbl" xml:lang="en-US" id="id_12960622_2734505_3_1">Physician group.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_PhysicianGroupMember_lbl" xml:lang="en-US" id="id_12960622_2734505_1_1">Physician Group [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_PhysicianGroupMember_lbl" xml:lang="en-US" id="id_12960622_2734505_2_1">Physician Group [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_PhysicianGroupMember" xlink:to="md_PhysicianGroupMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PlanNameAxis" xlink:label="us-gaap_PlanNameAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PlanNameAxis_lbl" xml:lang="en-US" id="id_12960622_2445234_1_1">Plan Name [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PlanNameAxis_lbl" xml:lang="en-US" id="id_12960622_2445234_2_1">Plan Name [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PlanNameAxis" xlink:to="us-gaap_PlanNameAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PlanNameDomain" xlink:label="us-gaap_PlanNameDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PlanNameDomain_lbl" xml:lang="en-US" id="id_12960622_2445571_1_1">Plan Name [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PlanNameDomain_lbl" xml:lang="en-US" id="id_12960622_2445571_2_1">Plan Name [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PlanNameDomain" xlink:to="us-gaap_PlanNameDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_PracticeSalariesAndBenefits" xlink:label="md_PracticeSalariesAndBenefits"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_PracticeSalariesAndBenefits_lbl" xml:lang="en-US" id="id_12960622_2489642_3_1">Practice salaries and benefits.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_PracticeSalariesAndBenefits_lbl" xml:lang="en-US" id="id_12960622_2489642_1_1">Practice Salaries and Benefits</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_PracticeSalariesAndBenefits_lbl" xml:lang="en-US" id="id_12960622_2489642_2_1">Practice salaries and benefits</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_PracticeSalariesAndBenefits" xlink:to="md_PracticeSalariesAndBenefits_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_PracticeSuppliesAndOtherOperatingExpenses" xlink:label="md_PracticeSuppliesAndOtherOperatingExpenses"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_PracticeSuppliesAndOtherOperatingExpenses_lbl" xml:lang="en-US" id="id_12960622_2552648_3_1">The aggregate amount of supplies and other operating expenses directly attributable to the physician practices.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_PracticeSuppliesAndOtherOperatingExpenses_lbl" xml:lang="en-US" id="id_12960622_2552648_1_1">Practice Supplies And Other Operating Expenses</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_PracticeSuppliesAndOtherOperatingExpenses_lbl" xml:lang="en-US" id="id_12960622_2552648_2_1">Practice supplies and other operating expenses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_PracticeSuppliesAndOtherOperatingExpenses" xlink:to="md_PracticeSuppliesAndOtherOperatingExpenses_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PreferredStockParOrStatedValuePerShare" xlink:label="us-gaap_PreferredStockParOrStatedValuePerShare"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PreferredStockParOrStatedValuePerShare_lbl" xml:lang="en-US" id="id_12960622_2445650_1_1">Preferred Stock, Par or Stated Value Per Share</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PreferredStockParOrStatedValuePerShare_lbl" xml:lang="en-US" id="id_12960622_2445650_2_1">Preferred stock, par value</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PreferredStockParOrStatedValuePerShare" xlink:to="us-gaap_PreferredStockParOrStatedValuePerShare_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PreferredStockSharesAuthorized" xlink:label="us-gaap_PreferredStockSharesAuthorized"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PreferredStockSharesAuthorized_lbl" xml:lang="en-US" id="id_12960622_2445652_1_1">Preferred Stock, Shares Authorized</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PreferredStockSharesAuthorized_lbl" xml:lang="en-US" id="id_12960622_2445652_2_1">Preferred stock, shares authorized</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PreferredStockSharesAuthorized" xlink:to="us-gaap_PreferredStockSharesAuthorized_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PreferredStockSharesIssued" xlink:label="us-gaap_PreferredStockSharesIssued"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PreferredStockSharesIssued_lbl" xml:lang="en-US" id="id_12960622_2445856_1_1">Preferred Stock, Shares Issued</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PreferredStockSharesIssued_lbl" xml:lang="en-US" id="id_12960622_2445856_2_1">Preferred stock, issued</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PreferredStockSharesIssued" xlink:to="us-gaap_PreferredStockSharesIssued_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PreferredStockValue" xlink:label="us-gaap_PreferredStockValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PreferredStockValue_lbl" xml:lang="en-US" id="id_12960622_2445656_1_1">Preferred Stock, Value, Issued</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PreferredStockValue_lbl" xml:lang="en-US" id="id_12960622_2445656_2_1">Preferred stock; $.01 par value; 1,000 shares authorized; none issued</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PreferredStockValue" xlink:to="us-gaap_PreferredStockValue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PrepaidExpenseCurrent" xlink:label="us-gaap_PrepaidExpenseCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PrepaidExpenseCurrent_lbl" xml:lang="en-US" id="id_12960622_2445954_1_1">Prepaid Expense, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PrepaidExpenseCurrent_lbl" xml:lang="en-US" id="id_12960622_2445954_2_1">Prepaid expenses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PrepaidExpenseCurrent" xlink:to="us-gaap_PrepaidExpenseCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_PriorPeriodAcquisitionsMember" xlink:label="md_PriorPeriodAcquisitionsMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_PriorPeriodAcquisitionsMember_lbl" xml:lang="en-US" id="id_12960622_2686524_3_1">Prior-period acquisitions.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_PriorPeriodAcquisitionsMember_lbl" xml:lang="en-US" id="id_12960622_2686524_1_1">Prior Period Acquisitions [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_PriorPeriodAcquisitionsMember_lbl" xml:lang="en-US" id="id_12960622_2686524_2_1">Prior-Period Acquisitions [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_PriorPeriodAcquisitionsMember" xlink:to="md_PriorPeriodAcquisitionsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation" xlink:label="us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation_lbl" xml:lang="en-US" id="id_12960622_2446351_1_1">Proceeds and Excess Tax Benefit from Share-based Compensation</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation_lbl" xml:lang="en-US" id="id_12960622_2446351_2_1">Cash proceeds received from the exercise of stock options</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation" xlink:to="us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ProceedsFromIssuanceOfCommonStock" xlink:label="us-gaap_ProceedsFromIssuanceOfCommonStock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ProceedsFromIssuanceOfCommonStock_lbl" xml:lang="en-US" id="id_12960622_2446016_1_1">Proceeds from Issuance of Common Stock</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ProceedsFromIssuanceOfCommonStock_lbl" xml:lang="en-US" id="id_12960622_2446016_2_1">Proceeds from issuance of common stock</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ProceedsFromIssuanceOfCommonStock" xlink:to="us-gaap_ProceedsFromIssuanceOfCommonStock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt" xlink:label="us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt_lbl" xml:lang="en-US" id="id_12960622_2446555_1_1">Proceeds from Issuance of Senior Long-term Debt</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt_lbl" xml:lang="en-US" id="id_12960622_2446555_2_1">Proceeds from issuance of senior notes</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt" xlink:to="us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ProceedsFromLinesOfCredit" xlink:label="us-gaap_ProceedsFromLinesOfCredit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ProceedsFromLinesOfCredit_lbl" xml:lang="en-US" id="id_12960622_2446560_1_1">Proceeds from Lines of Credit</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ProceedsFromLinesOfCredit_lbl" xml:lang="en-US" id="id_12960622_2446560_2_1">Borrowings on credit agreement</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ProceedsFromLinesOfCredit" xlink:to="us-gaap_ProceedsFromLinesOfCredit_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ProceedsFromMinorityShareholders" xlink:label="us-gaap_ProceedsFromMinorityShareholders"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ProceedsFromMinorityShareholders_lbl" xml:lang="en-US" id="id_12960622_2446027_1_1">Proceeds from Noncontrolling Interests</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ProceedsFromMinorityShareholders_lbl" xml:lang="en-US" id="id_12960622_2446027_2_1">Contribution from noncontrolling interests</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ProceedsFromMinorityShareholders" xlink:to="us-gaap_ProceedsFromMinorityShareholders_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ProceedsFromSaleMaturityAndCollectionsOfInvestments" xlink:label="us-gaap_ProceedsFromSaleMaturityAndCollectionsOfInvestments"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ProceedsFromSaleMaturityAndCollectionsOfInvestments_lbl" xml:lang="en-US" id="id_12960622_2446058_1_1">Proceeds from Sale, Maturity and Collection of Investments</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ProceedsFromSaleMaturityAndCollectionsOfInvestments_lbl" xml:lang="en-US" id="id_12960622_2446058_2_1">Proceeds from maturities of investments</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ProceedsFromSaleMaturityAndCollectionsOfInvestments" xlink:to="us-gaap_ProceedsFromSaleMaturityAndCollectionsOfInvestments_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ProductConcentrationRiskMember" xlink:label="us-gaap_ProductConcentrationRiskMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ProductConcentrationRiskMember_lbl" xml:lang="en-US" id="id_12960622_2446251_1_1">Product Concentration Risk [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ProductConcentrationRiskMember_lbl" xml:lang="en-US" id="id_12960622_2446251_2_1">Product Concentration Risk [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ProductConcentrationRiskMember" xlink:to="us-gaap_ProductConcentrationRiskMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ProductOrServiceAxis" xlink:label="us-gaap_ProductOrServiceAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ProductOrServiceAxis_lbl" xml:lang="en-US" id="id_12960622_2446084_1_1">Products and Services [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ProductOrServiceAxis_lbl" xml:lang="en-US" id="id_12960622_2446084_2_1">Products and Services [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ProductOrServiceAxis" xlink:to="us-gaap_ProductOrServiceAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ProductsAndServicesDomain" xlink:label="us-gaap_ProductsAndServicesDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ProductsAndServicesDomain_lbl" xml:lang="en-US" id="id_12960622_2446085_1_1">Products and Services [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ProductsAndServicesDomain_lbl" xml:lang="en-US" id="id_12960622_2446085_2_1">Products and Services [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ProductsAndServicesDomain" xlink:to="us-gaap_ProductsAndServicesDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_ProfessionalLiabilityCoveragePolicyTextBlock" xlink:label="md_ProfessionalLiabilityCoveragePolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ProfessionalLiabilityCoveragePolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2758345_3_1">Professional liability coverage policy.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ProfessionalLiabilityCoveragePolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2758345_1_1">Professional Liability Coverage Policy [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ProfessionalLiabilityCoveragePolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2758345_2_1">Professional Liability Coverage</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ProfessionalLiabilityCoveragePolicyTextBlock" xlink:to="md_ProfessionalLiabilityCoveragePolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ProfitLoss" xlink:label="us-gaap_ProfitLoss"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ProfitLoss_lbl" xml:lang="en-US" id="id_12960622_2446273_1_1">Net Income (Loss), Including Portion Attributable to Noncontrolling Interest</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ProfitLoss_lbl" xml:lang="en-US" id="id_12960622_2446273_2_1">Net income</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_ProfitLoss_lbl" xml:lang="en-US" id="id_12960622_2446273_6_1">Net income</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/verboseLabel" xlink:label="us-gaap_ProfitLoss_lbl" xml:lang="en-US" id="id_12960622_2446273_12_1">Net income (loss)</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ProfitLoss" xlink:to="us-gaap_ProfitLoss_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PropertyPlantAndEquipmentAbstract" xlink:label="us-gaap_PropertyPlantAndEquipmentAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentAbstract_lbl" xml:lang="en-US" id="id_12960622_2446277_1_1">Property, Plant and Equipment [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentAbstract_lbl" xml:lang="en-US" id="id_12960622_2446277_2_1">Property, Plant and Equipment [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentAbstract" xlink:to="us-gaap_PropertyPlantAndEquipmentAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis_lbl" xml:lang="en-US" id="id_12960622_2446463_1_1">Property, Plant and Equipment, Type [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis_lbl" xml:lang="en-US" id="id_12960622_2446463_2_1">Property, Plant and Equipment, Type [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_PropertyPlantAndEquipmentByTypeAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract" xlink:label="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract_lbl" xml:lang="en-US" id="id_12960622_2463077_3_1">Property Plant And Equipment Capitalized Interest Costs [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract_lbl" xml:lang="en-US" id="id_12960622_2463077_1_1">Property Plant And Equipment Capitalized Interest Costs [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract_lbl" xml:lang="en-US" id="id_12960622_2463077_2_1">Property Plant And Equipment Capitalized Interest Costs [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract" xlink:to="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock" xlink:label="us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2446640_1_1">Property, Plant and Equipment Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock_lbl" xml:lang="en-US" id="id_12960622_2446640_2_1">Property and Equipment</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock" xlink:to="us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PropertyPlantAndEquipmentGross" xlink:label="us-gaap_PropertyPlantAndEquipmentGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentGross_lbl" xml:lang="en-US" id="id_12960622_2446643_1_1">Property, Plant and Equipment, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentGross_lbl" xml:lang="en-US" id="id_12960622_2446643_2_1">Medical and other equipment held under capital leases</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentGross_lbl" xml:lang="en-US" id="id_12960622_2446643_6_1">Property and equipment, gross</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentGross" xlink:to="us-gaap_PropertyPlantAndEquipmentGross_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PropertyPlantAndEquipmentLineItems" xlink:label="us-gaap_PropertyPlantAndEquipmentLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentLineItems_lbl" xml:lang="en-US" id="id_12960622_2446648_1_1">Property, Plant and Equipment [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentLineItems_lbl" xml:lang="en-US" id="id_12960622_2446648_2_1">Property, Plant and Equipment [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentLineItems" xlink:to="us-gaap_PropertyPlantAndEquipmentLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PropertyPlantAndEquipmentNet" xlink:label="us-gaap_PropertyPlantAndEquipmentNet"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentNet_lbl" xml:lang="en-US" id="id_12960622_2446103_1_1">Property, Plant and Equipment, Net</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentNet_lbl" xml:lang="en-US" id="id_12960622_2446103_2_1">Property and equipment, net</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentNet_lbl" xml:lang="en-US" id="id_12960622_2446103_6_1">Property and equipment, net</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentNet" xlink:to="us-gaap_PropertyPlantAndEquipmentNet_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PropertyPlantAndEquipmentPolicyTextBlock" xlink:label="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2446468_1_1">Property, Plant and Equipment, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2446468_2_1">Property and Equipment</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock" xlink:to="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTextBlock" xlink:label="us-gaap_PropertyPlantAndEquipmentTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentTextBlock_lbl" xml:lang="en-US" id="id_12960622_2446290_1_1">Property, Plant and Equipment [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentTextBlock_lbl" xml:lang="en-US" id="id_12960622_2446290_2_1">Schedule of Property and Equipment</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentTextBlock" xlink:to="us-gaap_PropertyPlantAndEquipmentTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain_lbl" xml:lang="en-US" id="id_12960622_2446652_1_1">Property, Plant and Equipment, Type [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain_lbl" xml:lang="en-US" id="id_12960622_2446652_2_1">Property, Plant and Equipment, Type [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_PropertyPlantAndEquipmentTypeDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_PropertyPlantAndEquipmentUsefulLife" xlink:label="us-gaap_PropertyPlantAndEquipmentUsefulLife"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentUsefulLife_lbl" xml:lang="en-US" id="id_12960622_2446653_1_1">Property, Plant and Equipment, Useful Life</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentUsefulLife_lbl" xml:lang="en-US" id="id_12960622_2446653_2_1">Property and equipment estimated useful lives, years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentUsefulLife" xlink:to="us-gaap_PropertyPlantAndEquipmentUsefulLife_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_ProvisionAdjustmentForLossesRelatedToCurrentYear" xlink:label="md_ProvisionAdjustmentForLossesRelatedToCurrentYear"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ProvisionAdjustmentForLossesRelatedToCurrentYear_lbl" xml:lang="en-US" id="id_12960622_2510777_3_1">Provision (adjustment) for losses related to current year.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ProvisionAdjustmentForLossesRelatedToCurrentYear_lbl" xml:lang="en-US" id="id_12960622_2510777_1_1">Provision Adjustment For Losses Related To Current Year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ProvisionAdjustmentForLossesRelatedToCurrentYear_lbl" xml:lang="en-US" id="id_12960622_2510777_2_1">Provision (adjustment) for losses related to Current year</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ProvisionAdjustmentForLossesRelatedToCurrentYear" xlink:to="md_ProvisionAdjustmentForLossesRelatedToCurrentYear_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_ProvisionAdjustmentForLossesRelatedToPriorYear" xlink:label="md_ProvisionAdjustmentForLossesRelatedToPriorYear"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ProvisionAdjustmentForLossesRelatedToPriorYear_lbl" xml:lang="en-US" id="id_12960622_2491508_3_1">Provision (adjustment) for losses related to prior year.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ProvisionAdjustmentForLossesRelatedToPriorYear_lbl" xml:lang="en-US" id="id_12960622_2491508_1_1">Provision Adjustment For Losses Related To Prior Year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ProvisionAdjustmentForLossesRelatedToPriorYear_lbl" xml:lang="en-US" id="id_12960622_2491508_2_1">Provision (adjustment) for losses related to Prior years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ProvisionAdjustmentForLossesRelatedToPriorYear" xlink:to="md_ProvisionAdjustmentForLossesRelatedToPriorYear_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_PurchaseConsiderationLiability" xlink:label="md_PurchaseConsiderationLiability"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_PurchaseConsiderationLiability_lbl" xml:lang="en-US" id="id_12960622_2541276_3_1">Purchase consideration liability.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_PurchaseConsiderationLiability_lbl" xml:lang="en-US" id="id_12960622_2541276_1_1">Purchase Consideration Liability</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_PurchaseConsiderationLiability_lbl" xml:lang="en-US" id="id_12960622_2541276_2_1">Purchase consideration liability</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_PurchaseConsiderationLiability" xlink:to="md_PurchaseConsiderationLiability_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:label="us-gaap_QuarterlyFinancialInformationDisclosureAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_QuarterlyFinancialInformationDisclosureAbstract_lbl" xml:lang="en-US" id="id_12960622_2447192_1_1">Quarterly Financial Information Disclosure [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_QuarterlyFinancialInformationDisclosureAbstract_lbl" xml:lang="en-US" id="id_12960622_2447192_2_1">Quarterly Financial Information Disclosure [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_QuarterlyFinancialInformationDisclosureAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_QuarterlyFinancialInformationTextBlock" xlink:label="us-gaap_QuarterlyFinancialInformationTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_QuarterlyFinancialInformationTextBlock_lbl" xml:lang="en-US" id="id_12960622_2447193_1_1">Quarterly Financial Information [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_QuarterlyFinancialInformationTextBlock_lbl" xml:lang="en-US" id="id_12960622_2447193_2_1">Selected Quarterly Financial Information</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_QuarterlyFinancialInformationTextBlock" xlink:to="us-gaap_QuarterlyFinancialInformationTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_RadiologyAndTeleradiologyMember" xlink:label="md_RadiologyAndTeleradiologyMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_RadiologyAndTeleradiologyMember_lbl" xml:lang="en-US" id="id_12960622_3031709_3_1">Radiology and teleradiology.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_RadiologyAndTeleradiologyMember_lbl" xml:lang="en-US" id="id_12960622_3031709_1_1">Radiology And Teleradiology [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_RadiologyAndTeleradiologyMember_lbl" xml:lang="en-US" id="id_12960622_3031709_2_1">Radiology And Teleradiology [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_RadiologyAndTeleradiologyMember" xlink:to="md_RadiologyAndTeleradiologyMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_RangeAxis" xlink:label="us-gaap_RangeAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RangeAxis_lbl" xml:lang="en-US" id="id_12960622_2447194_1_1">Range [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_RangeAxis_lbl" xml:lang="en-US" id="id_12960622_2447194_2_1">Range [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RangeAxis" xlink:to="us-gaap_RangeAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_RangeMember" xlink:label="us-gaap_RangeMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RangeMember_lbl" xml:lang="en-US" id="id_12960622_2446806_1_1">Range [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_RangeMember_lbl" xml:lang="en-US" id="id_12960622_2446806_2_1">Range [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RangeMember" xlink:to="us-gaap_RangeMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis" xlink:label="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis_lbl" xml:lang="en-US" id="id_12960622_2446738_1_1">Nature of Uncertainty [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis_lbl" xml:lang="en-US" id="id_12960622_2446738_2_1">Nature of Uncertainty [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis" xlink:to="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ReceivablesAbstract" xlink:label="us-gaap_ReceivablesAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ReceivablesAbstract_lbl" xml:lang="en-US" id="id_12960622_2447033_1_1">Receivables [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ReceivablesAbstract_lbl" xml:lang="en-US" id="id_12960622_2447033_2_1">Receivables [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ReceivablesAbstract" xlink:to="us-gaap_ReceivablesAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock" xlink:label="md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2771184_3_1">Recently adopted accounting pronouncements policy.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2771184_1_1">Recently Adopted Accounting Pronouncements [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2771184_2_1">Recently Adopted Accounting Pronouncements</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock" xlink:to="md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember" xlink:label="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember_lbl" xml:lang="en-US" id="id_12960622_2661522_3_1">Redeem up to thirty five percentage of aggregate principal amount.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember_lbl" xml:lang="en-US" id="id_12960622_2661522_1_1">Redeem Up to Thirty Five Percentage of Aggregate Principal Amount [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember_lbl" xml:lang="en-US" id="id_12960622_2661522_2_1">Redeem up to 35% of Aggregate Principal Amount [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember" xlink:to="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_RegulatoryAssetsAbstract" xlink:label="md_RegulatoryAssetsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_RegulatoryAssetsAbstract_lbl" xml:lang="en-US" id="id_12960622_2469538_3_1">Regulatory Assets [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_RegulatoryAssetsAbstract_lbl" xml:lang="en-US" id="id_12960622_2469538_1_1">Regulatory Assets [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_RegulatoryAssetsAbstract_lbl" xml:lang="en-US" id="id_12960622_2469538_2_1">Regulatory Assets [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_RegulatoryAssetsAbstract" xlink:to="md_RegulatoryAssetsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_RepaymentsOfLinesOfCredit" xlink:label="us-gaap_RepaymentsOfLinesOfCredit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RepaymentsOfLinesOfCredit_lbl" xml:lang="en-US" id="id_12960622_2446940_1_1">Repayments of Lines of Credit</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_RepaymentsOfLinesOfCredit_lbl" xml:lang="en-US" id="id_12960622_2446940_14_1">Payments on credit agreement</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RepaymentsOfLinesOfCredit" xlink:to="us-gaap_RepaymentsOfLinesOfCredit_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_RepaymentsOfLongTermCapitalLeaseObligations" xlink:label="us-gaap_RepaymentsOfLongTermCapitalLeaseObligations"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RepaymentsOfLongTermCapitalLeaseObligations_lbl" xml:lang="en-US" id="id_12960622_2447319_1_1">Repayments of Long-term Capital Lease Obligations</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_RepaymentsOfLongTermCapitalLeaseObligations_lbl" xml:lang="en-US" id="id_12960622_2447319_14_1">Payments on capital lease obligations</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RepaymentsOfLongTermCapitalLeaseObligations" xlink:to="us-gaap_RepaymentsOfLongTermCapitalLeaseObligations_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_RestrictedAndDeferredStockUnitsMember" xlink:label="md_RestrictedAndDeferredStockUnitsMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_RestrictedAndDeferredStockUnitsMember_lbl" xml:lang="en-US" id="id_12960622_2738709_3_1">Restricted and deferred stock units.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_RestrictedAndDeferredStockUnitsMember_lbl" xml:lang="en-US" id="id_12960622_2738709_1_1">Restricted And Deferred Stock Units [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_RestrictedAndDeferredStockUnitsMember_lbl" xml:lang="en-US" id="id_12960622_2738709_2_1">Restricted and Deferred Stock Units [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_RestrictedAndDeferredStockUnitsMember" xlink:to="md_RestrictedAndDeferredStockUnitsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_RestrictedCashNoncurrent" xlink:label="us-gaap_RestrictedCashNoncurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RestrictedCashNoncurrent_lbl" xml:lang="en-US" id="id_12960622_2447527_1_1">Restricted Cash, Noncurrent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_RestrictedCashNoncurrent_lbl" xml:lang="en-US" id="id_12960622_2447527_2_1">Restricted cash</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RestrictedCashNoncurrent" xlink:to="us-gaap_RestrictedCashNoncurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_RestrictedStockMember" xlink:label="us-gaap_RestrictedStockMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RestrictedStockMember_lbl" xml:lang="en-US" id="id_12960622_2447533_1_1">Restricted Stock [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_RestrictedStockMember_lbl" xml:lang="en-US" id="id_12960622_2447533_2_1">Restricted Stock [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RestrictedStockMember" xlink:to="us-gaap_RestrictedStockMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_RetainedEarningsAccumulatedDeficit" xlink:label="us-gaap_RetainedEarningsAccumulatedDeficit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RetainedEarningsAccumulatedDeficit_lbl" xml:lang="en-US" id="id_12960622_2448061_1_1">Retained Earnings (Accumulated Deficit)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_RetainedEarningsAccumulatedDeficit_lbl" xml:lang="en-US" id="id_12960622_2448061_2_1">Retained earnings</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RetainedEarningsAccumulatedDeficit" xlink:to="us-gaap_RetainedEarningsAccumulatedDeficit_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RetainedEarningsMember_lbl" xml:lang="en-US" id="id_12960622_2447681_1_1">Retained Earnings [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_RetainedEarningsMember_lbl" xml:lang="en-US" id="id_12960622_2447681_2_1">Retained Earnings [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RetainedEarningsMember" xlink:to="us-gaap_RetainedEarningsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_RevenueRecognitionPolicyTextBlock" xlink:label="us-gaap_RevenueRecognitionPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RevenueRecognitionPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2447889_1_1">Revenue Recognition, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_RevenueRecognitionPolicyTextBlock_lbl" xml:lang="en-US" id="id_12960622_2447889_2_1">Revenue Recognition</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RevenueRecognitionPolicyTextBlock" xlink:to="us-gaap_RevenueRecognitionPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_RevolvingCreditFacilityMember" xlink:label="us-gaap_RevolvingCreditFacilityMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RevolvingCreditFacilityMember_lbl" xml:lang="en-US" id="id_12960622_2447745_1_1">Revolving Credit Facility [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_RevolvingCreditFacilityMember_lbl" xml:lang="en-US" id="id_12960622_2447745_2_1">Revolving Credit Facility [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RevolvingCreditFacilityMember" xlink:to="us-gaap_RevolvingCreditFacilityMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_SaleOfMinorityInterestPercentage" xlink:label="md_SaleOfMinorityInterestPercentage"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_SaleOfMinorityInterestPercentage_lbl" xml:lang="en-US" id="id_12960622_2790843_3_1">Sale of minority interest percentage.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_SaleOfMinorityInterestPercentage_lbl" xml:lang="en-US" id="id_12960622_2790843_1_1">Sale Of Minority Interest Percentage</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_SaleOfMinorityInterestPercentage_lbl" xml:lang="en-US" id="id_12960622_2790843_2_1">Sale of minority interest percentage</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_SaleOfMinorityInterestPercentage" xlink:to="md_SaleOfMinorityInterestPercentage_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_SalesRevenueServicesNetMember" xlink:label="us-gaap_SalesRevenueServicesNetMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SalesRevenueServicesNetMember_lbl" xml:lang="en-US" id="id_12960622_2447785_1_1">Sales Revenue, Services, Net [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SalesRevenueServicesNetMember_lbl" xml:lang="en-US" id="id_12960622_2447785_2_1">Sales Revenue, Services, Net [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SalesRevenueServicesNetMember" xlink:to="us-gaap_SalesRevenueServicesNetMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ScenarioUnspecifiedDomain" xlink:label="us-gaap_ScenarioUnspecifiedDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScenarioUnspecifiedDomain_lbl" xml:lang="en-US" id="id_12960622_2447936_1_1">Scenario, Unspecified [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScenarioUnspecifiedDomain_lbl" xml:lang="en-US" id="id_12960622_2447936_2_1">Scenario, Unspecified [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScenarioUnspecifiedDomain" xlink:to="us-gaap_ScenarioUnspecifiedDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock" xlink:label="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2448175_1_1">Schedule of Accounts, Notes, Loans and Financing Receivable [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2448175_2_1">Schedule of Accounts Receivable, Net</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock" xlink:to="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock" xlink:label="us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2447937_1_1">Schedule of Accounts Payable and Accrued Liabilities [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2447937_2_1">Schedule of Accounts Payable and Accrued Expenses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock" xlink:to="us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock" xlink:label="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2772286_3_1">Schedule of accrued professional liability.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2772286_1_1">Schedule Of Accrued Professional Liability [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2772286_2_1">Schedule of Accrued Professional Liability</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock" xlink:to="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable_lbl" xml:lang="en-US" id="id_12960622_2448346_1_1">Schedule of Business Acquisitions, by Acquisition [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable_lbl" xml:lang="en-US" id="id_12960622_2448346_2_1">Schedule of Business Acquisitions, by Acquisition [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_ScheduleOfCapitalLeaseObligationsTableTextBlock" xlink:label="md_ScheduleOfCapitalLeaseObligationsTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ScheduleOfCapitalLeaseObligationsTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2756388_3_1">Schedule of capital lease obligations.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ScheduleOfCapitalLeaseObligationsTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2756388_1_1">Schedule Of Capital Lease Obligations [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ScheduleOfCapitalLeaseObligationsTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2756388_2_1">Schedule of Capital Lease Obligations</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ScheduleOfCapitalLeaseObligationsTableTextBlock" xlink:to="md_ScheduleOfCapitalLeaseObligationsTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock" xlink:label="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2447821_1_1">Schedule of Components of Income Tax Expense (Benefit) [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2447821_2_1">Summary of Components of Income Tax Provision</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock" xlink:to="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ScheduleOfDebtTableTextBlock" xlink:label="us-gaap_ScheduleOfDebtTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfDebtTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2447959_1_1">Schedule of Debt [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfDebtTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2447959_2_1">Schedule of Long-Term Debt</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfDebtTableTextBlock" xlink:to="us-gaap_ScheduleOfDebtTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock" xlink:label="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2447960_1_1">Schedule of Deferred Tax Assets and Liabilities [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2447960_2_1">Significant Components of Deferred Income Tax Assets and Liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock" xlink:to="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock" xlink:label="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2448370_1_1">Schedule of Effective Income Tax Rate Reconciliation [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2448370_2_1">Schedule of Differences Between Effective Rate and United States Federal Income Tax Statutory Rate</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock" xlink:to="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis" xlink:label="us-gaap_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis_lbl" xml:lang="en-US" id="id_12960622_2447972_1_1">Investment, Name [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis_lbl" xml:lang="en-US" id="id_12960622_2447972_2_1">Investment, Name [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis" xlink:to="us-gaap_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable_lbl" xml:lang="en-US" id="id_12960622_2448385_1_1">Schedule of Finite-Lived Intangible Assets [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable_lbl" xml:lang="en-US" id="id_12960622_2448385_2_1">Schedule of Finite-Lived Intangible Assets [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:to="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2448229_1_1">Schedule of Finite-Lived Intangible Assets [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2448229_2_1">Summary of Intangible Assets, Net</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock" xlink:to="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock" xlink:label="us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2448231_1_1">Schedule of Future Minimum Lease Payments for Capital Leases [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2448231_2_1">Schedule of Amounts Due Under Terms of Capital Lease Obligations</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock" xlink:to="us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock" xlink:label="us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2448503_1_1">Schedule of Future Minimum Rental Payments for Operating Leases [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock_lbl" xml:lang="en-US" id="id_12960622_2448503_2_1">Schedule of Future Minimum Lease Payments under Non-Cancelable Operating Leases</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock" xlink:to="us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems" xlink:label="us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems_lbl" xml:lang="en-US" id="id_12960622_2447983_1_1">Schedule of Held-to-maturity Securities [Line Items]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2_lbl" xml:lang="en-US" id="id_12960622_2448686_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Remaining Contractual Term</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_lbl" xml:lang="en-US" id="id_12960622_2448698_2_1">Equity Award [Domain]</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice_lbl" xml:lang="en-US" id="id_12960622_2448699_1_1">Share-based Compensation Arrangements by Share-based Payment Award, Options, Exercises in Period, Weighted Average Exercise Price</label>
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    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareRepurchaseProgramAxis" xlink:to="us-gaap_ShareRepurchaseProgramAxis_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareRepurchaseProgramDomain_lbl" xml:lang="en-US" id="id_12960622_2449232_1_1">Share Repurchase Program [Domain]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ShortTermInvestmentMaturityPeriod_lbl" xml:lang="en-US" id="id_12960622_2638866_3_1">Short term investment maturity period.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ShortTermInvestmentMaturityPeriod_lbl" xml:lang="en-US" id="id_12960622_2638866_1_1">Short Term Investment Maturity Period</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SignificantAccountingPoliciesTextBlock_lbl" xml:lang="en-US" id="id_12960622_2449415_2_1">Summary of Significant Accounting Policies</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_SoftwareAndSoftwareDevelopmentCostsMember" xlink:label="us-gaap_SoftwareAndSoftwareDevelopmentCostsMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SoftwareAndSoftwareDevelopmentCostsMember_lbl" xml:lang="en-US" id="id_12960622_2449144_1_1">Software and Software Development Costs [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SoftwareAndSoftwareDevelopmentCostsMember_lbl" xml:lang="en-US" id="id_12960622_2449144_2_1">Software and Software Development Costs [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SoftwareAndSoftwareDevelopmentCostsMember" xlink:to="us-gaap_SoftwareAndSoftwareDevelopmentCostsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations" xlink:label="us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StatementEquityComponentsAxis_lbl" xml:lang="en-US" id="id_12960622_2448914_2_1">Equity Components [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_StatementEquityComponentsAxis_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StatementLineItems_lbl" xml:lang="en-US" id="id_12960622_2448916_2_1">Statement [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StatementLineItems_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StatementOfFinancialPositionAbstract_lbl" xml:lang="en-US" id="id_12960622_2449303_2_1">Statement of Financial Position [Abstract]</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans" xlink:label="us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans_lbl" xml:lang="en-US" id="id_12960622_2449334_1_1">Stock Issued During Period, Shares, Employee Stock Purchase Plans</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration_lbl" xml:lang="en-US" id="id_12960622_2614663_3_1">Stock issued during period shares restricted stock acquisition consideration.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration_lbl" xml:lang="en-US" id="id_12960622_2614663_1_1">Stock Issued During Period Shares Restricted Stock Acquisition Consideration</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration_lbl" xml:lang="en-US" id="id_12960622_2614663_2_1">Issuance of restricted stock for acquisition consideration, shares</label>
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    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_StockIssuedDuringPeriodSharesRestrictedStockAndVestingOfDeferredStock" xlink:label="md_StockIssuedDuringPeriodSharesRestrictedStockAndVestingOfDeferredStock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_StockIssuedDuringPeriodSharesRestrictedStockAndVestingOfDeferredStock_lbl" xml:lang="en-US" id="id_12960622_2611700_3_1">Stock issued during period shares restricted stock and vesting of deferred stock.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_StockIssuedDuringPeriodSharesRestrictedStockAndVestingOfDeferredStock_lbl" xml:lang="en-US" id="id_12960622_2611700_1_1">Stock Issued During Period Shares Restricted Stock And Vesting Of Deferred Stock</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation_lbl" xml:lang="en-US" id="id_12960622_2449337_1_1">Stock Issued During Period, Shares, Share-based Compensation, Net of Forfeitures</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation_lbl" xml:lang="en-US" id="id_12960622_2449337_2_1">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation" xlink:to="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross_lbl" xml:lang="en-US" id="id_12960622_2449476_1_1">Stock Issued During Period, Shares, Share-based Compensation, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross_lbl" xml:lang="en-US" id="id_12960622_2449476_2_1">Issuance of restricted stock, shares</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross" xlink:to="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" xlink:label="us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised_lbl" xml:lang="en-US" id="id_12960622_2449339_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration_lbl" xml:lang="en-US" id="id_12960622_2601297_3_1">Stock issued during period value restricted stock acquisition consideration.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration_lbl" xml:lang="en-US" id="id_12960622_2601297_1_1">Stock Issued During Period Value Restricted Stock Acquisition Consideration</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration_lbl" xml:lang="en-US" id="id_12960622_2601297_2_1">Issuance of restricted stock for acquisition consideration</label>
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    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_StockIssuedDuringPeriodValueRestrictedStockAndVestingOfDeferredStock" xlink:label="md_StockIssuedDuringPeriodValueRestrictedStockAndVestingOfDeferredStock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_StockIssuedDuringPeriodValueRestrictedStockAndVestingOfDeferredStock_lbl" xml:lang="en-US" id="id_12960622_2577916_3_1">Stock issued during period value restricted stock and vesting of deferred stock.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_StockIssuedDuringPeriodValueRestrictedStockAndVestingOfDeferredStock_lbl" xml:lang="en-US" id="id_12960622_2577916_1_1">Stock Issued During Period Value Restricted Stock And Vesting Of Deferred Stock</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_StockIssuedDuringPeriodValueRestrictedStockAndVestingOfDeferredStock_lbl" xml:lang="en-US" id="id_12960622_2577916_2_1">Issuance of restricted stock and vesting of deferred stock</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_StockIssuedDuringPeriodValueRestrictedStockAndVestingOfDeferredStock" xlink:to="md_StockIssuedDuringPeriodValueRestrictedStockAndVestingOfDeferredStock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures" xlink:label="us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures_lbl" xml:lang="en-US" id="id_12960622_2449345_1_1">Stock Issued During Period, Value, Restricted Stock Award, Forfeitures</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation_lbl" xml:lang="en-US" id="id_12960622_2449346_1_1">Stock Issued During Period, Value, Share-based Compensation, Net of Forfeitures</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation_lbl" xml:lang="en-US" id="id_12960622_2449346_2_1">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation" xlink:to="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross_lbl" xml:lang="en-US" id="id_12960622_2449484_1_1">Stock Issued During Period, Value, Share-based Compensation, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross_lbl" xml:lang="en-US" id="id_12960622_2449484_2_1">Issuance of restricted stock</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockRepurchasedDuringPeriodShares_lbl" xml:lang="en-US" id="id_12960622_2449350_1_1">Stock Repurchased During Period, Shares</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StockRepurchasedDuringPeriodShares_lbl" xml:lang="en-US" id="id_12960622_2449350_2_1">Repurchased common stock, shares</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_StockRepurchasedDuringPeriodShares_lbl" xml:lang="en-US" id="id_12960622_2449350_14_1">Repurchased common stock, shares</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockRepurchasedDuringPeriodShares" xlink:to="us-gaap_StockRepurchasedDuringPeriodShares_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_StockRepurchasedDuringPeriodValue" xlink:label="us-gaap_StockRepurchasedDuringPeriodValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockRepurchasedDuringPeriodValue_lbl" xml:lang="en-US" id="id_12960622_2449868_1_1">Stock Repurchased During Period, Value</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StockRepurchasedDuringPeriodValue_lbl" xml:lang="en-US" id="id_12960622_2449868_2_1">Common stock repurchased</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_StockRepurchaseProgramAuthorizedAmount1" xlink:label="us-gaap_StockRepurchaseProgramAuthorizedAmount1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockRepurchaseProgramAuthorizedAmount1_lbl" xml:lang="en-US" id="id_12960622_2449489_1_1">Stock Repurchase Program, Authorized Amount</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember_lbl" xml:lang="en-US" id="id_12960622_2709962_3_1">Two Thousand Fifteen Non Qualified Stock Purchase Plan [Member]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_UnamortizedDebtIssuanceExpenseCurrent_lbl" xml:lang="en-US" id="id_12960622_2558477_1_1">Unamortized Debt Issuance Expense Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="md_UnamortizedDebtIssuanceExpenseCurrent_lbl" xml:lang="en-US" id="id_12960622_2558477_14_1">Less: Current portion, unamortized debt issuance costs</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_UnamortizedDebtIssuanceExpenseNoncurrent_lbl" xml:lang="en-US" id="id_12960622_2585812_1_1">Unamortized Debt Issuance Expense Noncurrent</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_UnnamedCorporateJointVentureMember_lbl" xml:lang="en-US" id="id_12960622_2703562_1_1">Unnamed Corporate Joint Venture [Member]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_UnrecognizedTaxBenefits_lbl" xml:lang="en-US" id="id_12960622_2449810_1_1">Unrecognized Tax Benefits</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodStartLabel" xlink:label="us-gaap_UnrecognizedTaxBenefits_lbl" xml:lang="en-US" id="id_12960622_2449810_5_1">Balance at beginning of year</label>
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    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_UnrecognizedTaxBenefits" xlink:to="us-gaap_UnrecognizedTaxBenefits_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions" xlink:label="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions"/>
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    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate" xlink:label="md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate"/>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease" xlink:label="us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease_lbl" xml:lang="en-US" id="id_12960622_2450466_1_1">Unrecognized Tax Benefits, Period Increase (Decrease)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease_lbl" xml:lang="en-US" id="id_12960622_2450466_2_1">Increase (decrease) in uncertain tax position</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease" xlink:to="us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations_lbl" xml:lang="en-US" id="id_12960622_2450373_1_1">Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations_lbl" xml:lang="en-US" id="id_12960622_2450373_14_1">Decreases related to lapse of statutes of limitation</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations" xlink:to="us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate" xlink:label="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate_lbl" xml:lang="en-US" id="id_12960622_2450763_1_1">Unrecognized Tax Benefits that Would Impact Effective Tax Rate</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate_lbl" xml:lang="en-US" id="id_12960622_2450763_2_1">Unrecognized tax benefits that would impact effective tax rate</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate" xlink:to="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20171231.xsd#md_UnsecuredRevolvingCreditFacilityMember" xlink:label="md_UnsecuredRevolvingCreditFacilityMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_UnsecuredRevolvingCreditFacilityMember_lbl" xml:lang="en-US" id="id_12960622_2676801_3_1">Unsecured Revolving Credit Facility [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_UnsecuredRevolvingCreditFacilityMember_lbl" xml:lang="en-US" id="id_12960622_2676801_1_1">Unsecured Revolving Credit Facility [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_UnsecuredRevolvingCreditFacilityMember_lbl" xml:lang="en-US" id="id_12960622_2676801_2_1">Unsecured Revolving Credit Facility [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_UnsecuredRevolvingCreditFacilityMember" xlink:to="md_UnsecuredRevolvingCreditFacilityMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_UseOfEstimates" xlink:label="us-gaap_UseOfEstimates"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_UseOfEstimates_lbl" xml:lang="en-US" id="id_12960622_2450913_1_1">Use of Estimates, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_UseOfEstimates_lbl" xml:lang="en-US" id="id_12960622_2450913_2_1">Accounting Estimates and Assumptions</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_UseOfEstimates" xlink:to="us-gaap_UseOfEstimates_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_USGovernmentSponsoredEnterprisesDebtSecuritiesMember" xlink:label="us-gaap_USGovernmentSponsoredEnterprisesDebtSecuritiesMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_USGovernmentSponsoredEnterprisesDebtSecuritiesMember_lbl" xml:lang="en-US" id="id_12960622_2450396_1_1">US Government-sponsored Enterprises Debt Securities [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_USGovernmentSponsoredEnterprisesDebtSecuritiesMember_lbl" xml:lang="en-US" id="id_12960622_2450396_2_1">Federal Home Loan Securities [Member]</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_USStatesAndPoliticalSubdivisionsMember" xlink:label="us-gaap_USStatesAndPoliticalSubdivisionsMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_USStatesAndPoliticalSubdivisionsMember_lbl" xml:lang="en-US" id="id_12960622_2450398_1_1">US States and Political Subdivisions Debt Securities [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_USStatesAndPoliticalSubdivisionsMember_lbl" xml:lang="en-US" id="id_12960622_2450398_2_1">Municipal Debt Securities [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_USStatesAndPoliticalSubdivisionsMember" xlink:to="us-gaap_USStatesAndPoliticalSubdivisionsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ValuationAllowancesAndReservesAdjustments" xlink:label="us-gaap_ValuationAllowancesAndReservesAdjustments"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ValuationAllowancesAndReservesAdjustments_lbl" xml:lang="en-US" id="id_12960622_2450789_1_1">Valuation Allowances and Reserves, Additions for Adjustments</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ValuationAllowancesAndReservesAdjustments_lbl" xml:lang="en-US" id="id_12960622_2450789_2_1">Accounts receivable contractual adjustments and write-offs (net of recoveries)</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ValuationAllowancesAndReservesAdjustments" xlink:to="us-gaap_ValuationAllowancesAndReservesAdjustments_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ValuationAllowancesAndReservesBalance" xlink:label="us-gaap_ValuationAllowancesAndReservesBalance"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ValuationAllowancesAndReservesBalance_lbl" xml:lang="en-US" id="id_12960622_2450512_1_1">Valuation Allowances and Reserves, Balance</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodEndLabel" xlink:label="us-gaap_ValuationAllowancesAndReservesBalance_lbl" xml:lang="en-US" id="id_12960622_2450512_4_1">Balance at end of year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodStartLabel" xlink:label="us-gaap_ValuationAllowancesAndReservesBalance_lbl" xml:lang="en-US" id="id_12960622_2450512_5_1">Balance at beginning of year</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ValuationAllowancesAndReservesBalance" xlink:to="us-gaap_ValuationAllowancesAndReservesBalance_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_ValuationAllowancesAndReservesChargedToCostAndExpense" xlink:label="us-gaap_ValuationAllowancesAndReservesChargedToCostAndExpense"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ValuationAllowancesAndReservesChargedToCostAndExpense_lbl" xml:lang="en-US" id="id_12960622_2450790_1_1">Valuation Allowances and Reserves, Additions for Charges to Cost and Expense</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ValuationAllowancesAndReservesChargedToCostAndExpense_lbl" xml:lang="en-US" id="id_12960622_2450790_2_1">Amount charged against operating revenue</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ValuationAndQualifyingAccountsAbstract_lbl" xml:lang="en-US" id="id_12960622_2450517_1_1">Valuation and Qualifying Accounts [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ValuationAndQualifyingAccountsAbstract_lbl" xml:lang="en-US" id="id_12960622_2450517_2_1">Valuation and Qualifying Accounts [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ValuationAndQualifyingAccountsAbstract" xlink:to="us-gaap_ValuationAndQualifyingAccountsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_VariableRateAxis" xlink:label="us-gaap_VariableRateAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_VariableRateAxis_lbl" xml:lang="en-US" id="id_12960622_2450966_1_1">Variable Rate [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_VariableRateAxis_lbl" xml:lang="en-US" id="id_12960622_2450966_2_1">Variable Rate [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_VariableRateAxis" xlink:to="us-gaap_VariableRateAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_VariableRateDomain" xlink:label="us-gaap_VariableRateDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_VariableRateDomain_lbl" xml:lang="en-US" id="id_12960622_2450967_1_1">Variable Rate [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_VariableRateDomain_lbl" xml:lang="en-US" id="id_12960622_2450967_2_1">Variable Rate [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_VariableRateDomain" xlink:to="us-gaap_VariableRateDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2017/elts/us-gaap-2017-01-31.xsd#us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding_lbl" xml:lang="en-US" id="id_12960622_2450464_1_1">Weighted Average Number of Shares Outstanding, Diluted</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding_lbl" xml:lang="en-US" id="id_12960622_2450464_2_1">Diluted</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding_lbl" xml:lang="en-US" id="id_12960622_2450464_6_1">Weighted average number of common and common equivalent shares outstanding</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic_lbl" xml:lang="en-US" id="id_12960622_2451135_2_1">Basic</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/verboseLabel" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic_lbl" xml:lang="en-US" id="id_12960622_2451135_12_1">Weighted average number of common shares outstanding</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:to="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic_lbl"/>
  </labelLink>
</linkbase>
</XBRL>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-101.PRE
<SEQUENCE>17
<FILENAME>md-20171231_pre.xml
<DESCRIPTION>XBRL TAXONOMY EXTENSION PRESENTATION LINKBASE
<TEXT>
<XBRL>
<?xml version="1.0" encoding="US-ASCII"?>
<!-- DFS Xcelerate Taxonomy Presentation Linkbase - http://www.dfsco.com/financial-services/ -->
<!-- Version: 6.23.6 -->
<!-- Round: 5 -->
<!-- Creation date: 2018-02-14T15:44:06Z -->
<!-- Copyright (c) 2017 Donnelley Financial, LLC. All Rights Reserved. -->
<linkbase xmlns="http://www.xbrl.org/2003/linkbase"
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  xmlns:xlink="http://www.w3.org/1999/xlink"
  xsi:schemaLocation="http://www.xbrl.org/2003/linkbase http://www.xbrl.org/2003/xbrl-linkbase-2003-12-31.xsd">
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  <roleRef xlink:type="simple" xlink:href="md-20171231.xsd#DisclosureGoodwillAndIntangibleAssetsAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20171231.xsd#DisclosureGoodwillAndIntangibleAssetsSummaryOfIntangibleAssetsNet" roleURI="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsSummaryOfIntangibleAssetsNet"/>
  <roleRef xlink:type="simple" xlink:href="md-20171231.xsd#DisclosureGoodwillAndIntangibleAssetsAmortizationExpensesForExistingIntangibleAssetsForTheNextFiveYears" roleURI="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAmortizationExpensesForExistingIntangibleAssetsForTheNextFiveYears"/>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6778294240">
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<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Document and Entity Information - USD ($)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
<th class="th" colspan="1"></th>
<th class="th" colspan="1"></th>
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<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Feb. 09, 2018</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
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<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_DocumentAndEntityInformationAbstract', window );"><strong>Document And Entity Information [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_DocumentType', window );">Document Type</a></td>
<td class="text">10-K<span></span>
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<td class="text">&#160;<span></span>
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<td class="text">&#160;<span></span>
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<td class="text">false<span></span>
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<td class="text">&#160;<span></span>
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<td class="text">&#160;<span></span>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_DocumentPeriodEndDate', window );">Document Period End Date</a></td>
<td class="text">Dec. 31,  2017<span></span>
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<td class="text">&#160;<span></span>
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<td class="text">&#160;<span></span>
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<td class="text">2017<span></span>
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<td class="text">&#160;<span></span>
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<td class="text">&#160;<span></span>
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<td class="text">FY<span></span>
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<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_TradingSymbol', window );">Trading Symbol</a></td>
<td class="text">MD<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityRegistrantName', window );">Entity Registrant Name</a></td>
<td class="text">MEDNAX, INC.<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityCentralIndexKey', window );">Entity Central Index Key</a></td>
<td class="text">0000893949<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_CurrentFiscalYearEndDate', window );">Current Fiscal Year End Date</a></td>
<td class="text">--12-31<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityWellKnownSeasonedIssuer', window );">Entity Well-known Seasoned Issuer</a></td>
<td class="text">Yes<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityCurrentReportingStatus', window );">Entity Current Reporting Status</a></td>
<td class="text">Yes<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityVoluntaryFilers', window );">Entity Voluntary Filers</a></td>
<td class="text">No<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityFilerCategory', window );">Entity Filer Category</a></td>
<td class="text">Large Accelerated Filer<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityCommonStockSharesOutstanding', window );">Entity Common Stock, Shares Outstanding</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">93,795,535<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityPublicFloat', window );">Entity Public Float</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 4,785,069,881<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_AmendmentFlag">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>If the value is true, then the document is an amendment to previously-filed/accepted document.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_AmendmentFlag</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:booleanItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_CurrentFiscalYearEndDate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>End date of current fiscal year in the format --MM-DD.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_CurrentFiscalYearEndDate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:gMonthDayItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_DocumentFiscalPeriodFocus">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>This is focus fiscal period of the document report. For a first quarter 2006 quarterly report, which may also provide financial information from prior periods, the first fiscal quarter should be given as the fiscal period focus. Values: FY, Q1, Q2, Q3, Q4, H1, H2, M9, T1, T2, T3, M8, CY.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_DocumentFiscalPeriodFocus</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>dei:fiscalPeriodItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_DocumentFiscalYearFocus">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>This is focus fiscal year of the document report in CCYY format. For a 2006 annual report, which may also provide financial information from prior periods, fiscal 2006 should be given as the fiscal year focus. Example: 2006.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_DocumentFiscalYearFocus</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:gYearItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_DocumentPeriodEndDate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The end date of the period reflected on the cover page if a periodic report. For all other reports and registration statements containing historical data, it is the date up through which that historical data is presented.  If there is no historical data in the report, use the filing date. The format of the date is CCYY-MM-DD.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_DocumentPeriodEndDate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:dateItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_DocumentType">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The type of document being provided (such as 10-K, 10-Q, 485BPOS, etc). The document type is limited to the same value as the supporting SEC submission type, or the word "Other".</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_DocumentType</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>dei:submissionTypeItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityCentralIndexKey">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>A unique 10-digit SEC-issued value to identify entities that have filed disclosures with the SEC. It is commonly abbreviated as CIK.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher SEC<br> -Name Regulation 12B<br> -Number 240<br> -Section 12b<br> -Subsection 1<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityCentralIndexKey</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>dei:centralIndexKeyItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityCommonStockSharesOutstanding">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Indicate number of shares or other units outstanding of each of registrant's classes of capital or common stock or other ownership interests, if and as stated on cover of related periodic report. Where multiple classes or units exist define each class/interest by adding class of stock items such as Common Class A [Member], Common Class B [Member] or Partnership Interest [Member] onto the Instrument [Domain] of the Entity Listings, Instrument.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityCommonStockSharesOutstanding</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityCurrentReportingStatus">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Indicate "Yes" or "No" whether registrants (1) have filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that registrants were required to file such reports), and (2) have been subject to such filing requirements for the past 90 days. This information should be based on the registrant's current or most recent filing containing the related disclosure.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityCurrentReportingStatus</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>dei:yesNoItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityFilerCategory">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Indicate whether the registrant is one of the following: (1) Large Accelerated Filer, (2) Accelerated Filer, (3) Non-accelerated Filer, (4) Smaller Reporting Company (Non-accelerated) or (5) Smaller Reporting Accelerated Filer. Definitions of these categories are stated in Rule 12b-2 of the Exchange Act. This information should be based on the registrant's current or most recent filing containing the related disclosure.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityFilerCategory</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>dei:filerCategoryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityPublicFloat">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>State aggregate market value of voting and non-voting common equity held by non-affiliates computed by reference to price at which the common equity was last sold, or average bid and asked price of such common equity, as of the last business day of registrant's most recently completed second fiscal quarter. The public float should be reported on the cover page of the registrants form 10K.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityPublicFloat</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityRegistrantName">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The exact name of the entity filing the report as specified in its charter, which is required by forms filed with the SEC.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher SEC<br> -Name Regulation 12B<br> -Number 240<br> -Section 12b<br> -Subsection 1<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityRegistrantName</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:normalizedStringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityVoluntaryFilers">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Indicate "Yes" or "No" if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityVoluntaryFilers</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>dei:yesNoItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityWellKnownSeasonedIssuer">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Indicate "Yes" or "No" if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Is used on Form Type: 10-K, 10-Q, 8-K, 20-F, 6-K, 10-K/A, 10-Q/A, 20-F/A, 6-K/A, N-CSR, N-Q, N-1A.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityWellKnownSeasonedIssuer</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>dei:yesNoItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_TradingSymbol">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Trading symbol of an instrument as listed on an exchange.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_TradingSymbol</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:normalizedStringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_DocumentAndEntityInformationAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Document And Entity Information.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_DocumentAndEntityInformationAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>20
<FILENAME>R2.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
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<body>
<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6778706160">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Consolidated Balance Sheets - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AssetsCurrentAbstract', window );"><strong>Current assets:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CashAndCashEquivalentsAtCarryingValue', window );">Cash and cash equivalents</a></td>
<td class="nump">$ 60,200<span></span>
</td>
<td class="nump">$ 55,698<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesCurrent', window );">Short-term investments</a></td>
<td class="nump">10,292<span></span>
</td>
<td class="nump">11,286<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccountsReceivableNetCurrent', window );">Accounts receivable, net</a></td>
<td class="nump">503,999<span></span>
</td>
<td class="nump">495,276<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PrepaidExpenseCurrent', window );">Prepaid expenses</a></td>
<td class="nump">15,584<span></span>
</td>
<td class="nump">11,051<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OtherAssetsCurrent', window );">Other assets</a></td>
<td class="nump">37,160<span></span>
</td>
<td class="nump">13,817<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AssetsCurrent', window );">Total current assets</a></td>
<td class="nump">627,235<span></span>
</td>
<td class="nump">587,128<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RestrictedCashNoncurrent', window );">Restricted cash</a></td>
<td class="nump">20,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesNoncurrent', window );">Investments</a></td>
<td class="nump">80,682<span></span>
</td>
<td class="nump">78,975<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentNet', window );">Property and equipment, net</a></td>
<td class="nump">123,536<span></span>
</td>
<td class="nump">103,068<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_Goodwill', window );">Goodwill</a></td>
<td class="nump">4,283,963<span></span>
</td>
<td class="nump">3,845,157<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsNet', window );">Intangible assets, net</a></td>
<td class="nump">639,928<span></span>
</td>
<td class="nump">668,529<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OtherAssetsNoncurrent', window );">Other assets</a></td>
<td class="nump">91,934<span></span>
</td>
<td class="nump">56,543<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_Assets', window );">Total assets</a></td>
<td class="nump">5,867,278<span></span>
</td>
<td class="nump">5,339,400<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LiabilitiesCurrentAbstract', window );"><strong>Current liabilities:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent', window );">Accounts payable and accrued expenses</a></td>
<td class="nump">438,017<span></span>
</td>
<td class="nump">407,938<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent', window );">Current portion of long-term debt and capital lease obligations</a></td>
<td class="nump">1,401<span></span>
</td>
<td class="nump">22,054<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccruedIncomeTaxesCurrent', window );">Income taxes payable</a></td>
<td class="nump">92,007<span></span>
</td>
<td class="nump">18,957<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LiabilitiesCurrent', window );">Total current liabilities</a></td>
<td class="nump">531,425<span></span>
</td>
<td class="nump">448,949<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LongTermLineOfCredit', window );">Line of credit</a></td>
<td class="nump">1,110,500<span></span>
</td>
<td class="nump">783,500<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit', window );">Long-term debt and capital lease obligations, net</a></td>
<td class="nump">740,923<span></span>
</td>
<td class="nump">900,128<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent', window );">Long-term professional liabilities</a></td>
<td class="nump">212,274<span></span>
</td>
<td class="nump">173,080<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxLiabilitiesNoncurrent', window );">Deferred income taxes</a></td>
<td class="nump">147,797<span></span>
</td>
<td class="nump">227,802<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OtherLiabilitiesNoncurrent', window );">Other liabilities</a></td>
<td class="nump">57,905<span></span>
</td>
<td class="nump">45,174<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_Liabilities', window );">Total liabilities</a></td>
<td class="nump">2,800,824<span></span>
</td>
<td class="nump">2,578,633<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommitmentsAndContingencies', window );">Commitments and contingencies</a></td>
<td class="text"> <span></span>
</td>
<td class="text"> <span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockholdersEquityAbstract', window );"><strong>Shareholders' equity:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PreferredStockValue', window );">Preferred stock; $.01 par value; 1,000 shares authorized; none issued</a></td>
<td class="text"> <span></span>
</td>
<td class="text"> <span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommonStockValue', window );">Common stock; $.01 par value; 200,000 shares authorized; 93,721 and 93,718 shares issued and outstanding, respectively</a></td>
<td class="nump">937<span></span>
</td>
<td class="nump">937<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdditionalPaidInCapitalCommonStock', window );">Additional paid-in capital</a></td>
<td class="nump">1,017,328<span></span>
</td>
<td class="nump">974,304<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RetainedEarningsAccumulatedDeficit', window );">Retained earnings</a></td>
<td class="nump">2,048,189<span></span>
</td>
<td class="nump">1,785,526<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockholdersEquity', window );">Total shareholders' equity</a></td>
<td class="nump">3,066,454<span></span>
</td>
<td class="nump">2,760,767<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LiabilitiesAndStockholdersEquity', window );">Total liabilities and shareholders' equity</a></td>
<td class="nump">$ 5,867,278<span></span>
</td>
<td class="nump">$ 5,339,400<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Accounts payable and accrued liabilities excluding accrued income taxes current.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Long term debt and capital lease obligations excluding long term line of credit.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AccountsReceivableNetCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount due from customers or clients, within one year of the balance sheet date (or the normal operating cycle, whichever is longer), for goods or services (including trade receivables) that have been delivered or sold in the normal course of business, reduced to the estimated net realizable fair value by an allowance established by the entity of the amount it deems uncertain of collection.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(3))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(4))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AccountsReceivableNetCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AccruedIncomeTaxesCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Carrying amount as of the balance sheet date of the unpaid sum of the known and estimated amounts payable to satisfy all currently due domestic and foreign income tax obligations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-03(a)(15)(b)(1))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879938&amp;loc=d3e572229-122910<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(20))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-03(15)(1))<br> -URI http://asc.fasb.org/extlink&amp;oid=6876686&amp;loc=d3e534808-122878<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AccruedIncomeTaxesCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AdditionalPaidInCapitalCommonStock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Value received from shareholders in common stock-related transactions that are in excess of par value or stated value and amounts received from other stock-related transactions. Includes only common stock transactions (excludes preferred stock transactions). May be called contributed capital, capital in excess of par, capital surplus, or paid-in capital.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(30)(a)(1))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AdditionalPaidInCapitalCommonStock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_Assets">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Sum of the carrying amounts as of the balance sheet date of all assets that are recognized. Assets are probable future economic benefits obtained or controlled by an entity as a result of past transactions or events.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-03(a)(12))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879938&amp;loc=d3e572229-122910<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-03(11))<br> -URI http://asc.fasb.org/extlink&amp;oid=6876686&amp;loc=d3e534808-122878<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_Assets</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AssetsCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Sum of the carrying amounts as of the balance sheet date of all assets that are expected to be realized in cash, sold, or consumed within one year (or the normal operating cycle, if longer). Assets are probable future economic benefits obtained or controlled by an entity as a result of past transactions or events.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.9)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6801-107765<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6676-107765<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AssetsCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AssetsCurrentAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AssetsCurrentAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CashAndCashEquivalentsAtCarryingValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of currency on hand as well as demand deposits with banks or financial institutions. Includes other kinds of accounts that have the general characteristics of demand deposits. Also includes short-term, highly liquid investments that are both readily convertible to known amounts of cash and so near their maturity that they present insignificant risk of changes in value because of changes in interest rates. Excludes cash and cash equivalents within disposal group and discontinued operation.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6676-107765<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3044-108585<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.1)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CashAndCashEquivalentsAtCarryingValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommitmentsAndContingencies">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Represents the caption on the face of the balance sheet to indicate that the entity has entered into (1) purchase or supply arrangements that will require expending a portion of its resources to meet the terms thereof, and (2) is exposed to potential losses or, less frequently, gains, arising from (a) possible claims against a company's resources due to future performance under contract terms, and (b) possible losses or likely gains from uncertainties that will ultimately be resolved when one or more future events that are deemed likely to occur do occur or fail to occur.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-03.(a),19)<br> -URI http://asc.fasb.org/extlink&amp;oid=6879938&amp;loc=d3e572229-122910<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 450<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=82911808&amp;loc=d3e14326-108349<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-03.17)<br> -URI http://asc.fasb.org/extlink&amp;oid=6876686&amp;loc=d3e534808-122878<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.25)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CommitmentsAndContingencies</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommonStockValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Aggregate par or stated value of issued nonredeemable common stock (or common stock redeemable solely at the option of the issuer). This item includes treasury stock repurchased by the entity. Note: elements for number of nonredeemable common shares, par value and other disclosure concepts are in another section within stockholders' equity.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CommonStockValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxLiabilitiesNoncurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount, after deferred tax asset, of deferred tax liability attributable to taxable differences, with jurisdictional netting and classified as noncurrent.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 45<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84176650&amp;loc=d3e31931-109318<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 45<br> -Paragraph 9<br> -URI http://asc.fasb.org/extlink&amp;oid=84176650&amp;loc=d3e31958-109318<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 45<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=84176650&amp;loc=d3e31917-109318<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxLiabilitiesNoncurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FiniteLivedIntangibleAssetsNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after amortization of assets, excluding financial assets and goodwill, lacking physical substance with a finite life.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsNet</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_Goodwill">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=35741047&amp;loc=d3e13816-109267<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 20<br> -Section 45<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6388280&amp;loc=d3e13770-109266<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 20<br> -Section 45<br> -Paragraph 5<br> -URI http://asc.fasb.org/extlink&amp;oid=77989000&amp;loc=SL49117168-202975<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_Goodwill</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_HeldToMaturitySecuritiesCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after other than temporary impairment (OTTI) accretion, of investments in debt securities classified as held-to-maturity, expected to be converted to cash, sold or exchanged within one year or the normal operating cycle.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=82896770&amp;loc=d3e26626-111562<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 25<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=75030427&amp;loc=d3e22054-111558<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_HeldToMaturitySecuritiesCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_HeldToMaturitySecuritiesNoncurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after other than temporary impairment (OTTI) accretion, of investments in debt securities classified as held-to-maturity, not expected to be converted to cash, sold or exchanged within one year or the normal operating cycle, if longer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 25<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=75030427&amp;loc=d3e22054-111558<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=82896770&amp;loc=d3e26626-111562<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_HeldToMaturitySecuritiesNoncurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_Liabilities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Sum of the carrying amounts as of the balance sheet date of all liabilities that are recognized. Liabilities are probable future sacrifices of economic benefits arising from present obligations of an entity to transfer assets or provide services to other entities in the future.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.19-26)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_Liabilities</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LiabilitiesAndStockholdersEquity">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of liabilities and equity items, including the portion of equity attributable to noncontrolling interests, if any.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-03(23))<br> -URI http://asc.fasb.org/extlink&amp;oid=6876686&amp;loc=d3e534808-122878<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-03(a)(25))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879938&amp;loc=d3e572229-122910<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(32))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LiabilitiesAndStockholdersEquity</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LiabilitiesCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Total obligations incurred as part of normal operations that are expected to be paid during the following twelve months or within one business cycle, if longer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.21)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LiabilitiesCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LiabilitiesCurrentAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LiabilitiesCurrentAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of long-term debt and capital leases due within one year or the normal operating cycle, if longer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.20)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LongTermLineOfCredit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The carrying value as of the balance sheet date of the noncurrent portion of long-term obligations drawn from a line of credit, which is a bank's commitment to make loans up to a specific amount. Examples of items that might be included in the application of this element may consist of letters of credit, standby letters of credit, and revolving credit arrangements, under which borrowings can be made up to a maximum amount as of any point in time conditional on satisfaction of specified terms before, as of and after the date of drawdowns on the line. Includes short-term obligations that would normally be classified as current liabilities but for which (a) postbalance sheet date issuance of a long term obligation to refinance the short term obligation on a long term basis, or (b) the enterprise has entered into a financing agreement that clearly permits the enterprise to refinance the short-term obligation on a long term basis and the following conditions are met (1) the agreement does not expire within 1 year and is not cancelable by the lender except for violation of an objectively determinable provision, (2) no violation exists at the BS date, and (3) the lender has entered into the financing agreement is expected to be financially capable of honoring the agreement.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.22)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 470<br> -SubTopic 10<br> -Section 45<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=99376301&amp;loc=d3e1314-112600<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 470<br> -SubTopic 10<br> -Section 45<br> -Paragraph 14<br> -URI http://asc.fasb.org/extlink&amp;oid=99376301&amp;loc=d3e1336-112600<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LongTermLineOfCredit</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of the noncurrent portion of the accrued liability on an undiscounted basis for malpractice claims (including general and professional liability).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 450<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=82911808&amp;loc=d3e14326-108349<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OtherAssetsCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of current assets classified as other.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.8)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OtherAssetsCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OtherAssetsNoncurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of noncurrent assets classified as other.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.17)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OtherAssetsNoncurrent</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OtherLiabilitiesNoncurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of liabilities classified as other, due after one year or the normal operating cycle, if longer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.24)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OtherLiabilitiesNoncurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<td><strong> Balance Type:</strong></td>
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<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PreferredStockValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Aggregate par or stated value of issued nonredeemable preferred stock (or preferred stock redeemable solely at the option of the issuer). This item includes treasury stock repurchased by the entity. Note: elements for number of nonredeemable preferred shares, par value and other disclosure concepts are in another section within stockholders' equity.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(28))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PreferredStockValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PrepaidExpenseCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of asset related to consideration paid in advance for costs that provide economic benefits within a future period of one year or the normal operating cycle, if longer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6787-107765<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 340<br> -SubTopic 10<br> -Section 05<br> -Paragraph 5<br> -URI http://asc.fasb.org/extlink&amp;oid=68074540&amp;loc=d3e5879-108316<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 1<br> -Subparagraph (g)<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6676-107765<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PrepaidExpenseCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<td><strong> Balance Type:</strong></td>
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<td><strong> Period Type:</strong></td>
<td>instant</td>
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</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after accumulated depreciation, depletion and amortization of physical assets used in the normal conduct of business to produce goods and services and not intended for resale. Examples include, but are not limited to, land, buildings, machinery and equipment, office equipment, and furniture and fixtures.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(13))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(14))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-03(a)(8))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879938&amp;loc=d3e572229-122910<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentNet</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_RestrictedCashNoncurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash restricted as to withdrawal or usage, classified as noncurrent. Cash includes, but is not limited to, currency on hand, demand deposits with banks or financial institutions, and other accounts with general characteristics of demand deposits.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=SL98516268-108586<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(17))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 4<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6812-107765<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3044-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RestrictedCashNoncurrent</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Data Type:</strong></td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_RetainedEarningsAccumulatedDeficit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cumulative amount of the reporting entity's undistributed earnings or deficit.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-03(a)(23)(a)(4))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879938&amp;loc=d3e572229-122910<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.3-04)<br> -URI http://asc.fasb.org/extlink&amp;oid=27012166&amp;loc=d3e187085-122770<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(30)(a)(3))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RetainedEarningsAccumulatedDeficit</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
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<td><strong> Period Type:</strong></td>
<td>instant</td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockholdersEquity">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Total of all stockholders' equity (deficit) items, net of receivables from officers, directors, owners, and affiliates of the entity which are attributable to the parent. The amount of the economic entity's stockholders' equity attributable to the parent excludes the amount of stockholders' equity which is allocable to that ownership interest in subsidiary equity which is not attributable to the parent (noncontrolling interest, minority interest). This excludes temporary equity and is sometimes called permanent equity.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(30))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 310<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SAB Topic 4.E)<br> -URI http://asc.fasb.org/extlink&amp;oid=27010918&amp;loc=d3e74512-122707<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(31))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockholdersEquity</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
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<td><strong> Period Type:</strong></td>
<td>instant</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockholdersEquityAbstract</td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6778258064">
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<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Consolidated Balance Sheets (Parenthetical) - $ / shares<br></strong></div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StatementOfFinancialPositionAbstract', window );"><strong>Statement of Financial Position [Abstract]</strong></a></td>
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<td class="nump">$ 0.01<span></span>
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</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommonStockParOrStatedValuePerShare', window );">Common stock, par value</a></td>
<td class="nump">$ 0.01<span></span>
</td>
<td class="nump">$ 0.01<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommonStockSharesAuthorized', window );">Common stock, shares authorized</a></td>
<td class="nump">200,000,000<span></span>
</td>
<td class="nump">200,000,000<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommonStockSharesIssued', window );">Common stock, shares issued</a></td>
<td class="nump">93,721,000<span></span>
</td>
<td class="nump">93,718,000<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommonStockSharesOutstanding', window );">Common stock, shares outstanding</a></td>
<td class="nump">93,721,000<span></span>
</td>
<td class="nump">93,718,000<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommonStockParOrStatedValuePerShare">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Face amount or stated value per share of common stock.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CommonStockParOrStatedValuePerShare</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommonStockSharesAuthorized">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The maximum number of common shares permitted to be issued by an entity's charter and bylaws.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CommonStockSharesAuthorized</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommonStockSharesIssued">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Total number of common shares of an entity that have been sold or granted to shareholders (includes common shares that were issued, repurchased and remain in the treasury). These shares represent capital invested by the firm's shareholders and owners, and may be all or only a portion of the number of shares authorized. Shares issued include shares outstanding and shares held in the treasury.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CommonStockSharesIssued</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommonStockSharesOutstanding">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of shares of common stock outstanding. Common stock represent the ownership interest in a corporation.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84159872&amp;loc=d3e21463-112644<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CommonStockSharesOutstanding</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PreferredStockParOrStatedValuePerShare">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Face amount or stated value per share of preferred stock nonredeemable or redeemable solely at the option of the issuer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(28))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PreferredStockParOrStatedValuePerShare</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PreferredStockSharesAuthorized">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The maximum number of nonredeemable preferred shares (or preferred stock redeemable solely at the option of the issuer) permitted to be issued by an entity's charter and bylaws.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(28))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PreferredStockSharesAuthorized</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PreferredStockSharesIssued">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Total number of nonredeemable preferred shares (or preferred stock redeemable solely at the option of the issuer) issued to shareholders (includes related preferred shares that were issued, repurchased, and remain in the treasury). May be all or portion of the number of preferred shares authorized. Excludes preferred shares that are classified as debt.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(28))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PreferredStockSharesIssued</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StatementOfFinancialPositionAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StatementOfFinancialPositionAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6779376816">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Consolidated Statements of Income - USD ($)<br> shares in Thousands, $ in Thousands</strong></div></th>
<th class="th" colspan="8">3 Months Ended</th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Sep. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Sep. 30, 2016</div></th>
<th class="th"><div>Jun. 30, 2016</div></th>
<th class="th"><div>Mar. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeStatementAbstract', window );"><strong>Income Statement [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HealthCareOrganizationRevenue', window );">Net revenue</a></td>
<td class="nump">$ 910,820<span></span>
</td>
<td class="nump">$ 868,951<span></span>
</td>
<td class="nump">$ 842,944<span></span>
</td>
<td class="nump">$ 835,597<span></span>
</td>
<td class="nump">$ 830,770<span></span>
</td>
<td class="nump">$ 828,006<span></span>
</td>
<td class="nump">$ 771,759<span></span>
</td>
<td class="nump">$ 752,624<span></span>
</td>
<td class="nump">$ 3,458,312<span></span>
</td>
<td class="nump">$ 3,183,159<span></span>
</td>
<td class="nump">$ 2,779,996<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingExpensesAbstract', window );"><strong>Operating expenses:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_PracticeSalariesAndBenefits', window );">Practice salaries and benefits</a></td>
<td class="nump">617,455<span></span>
</td>
<td class="nump">586,476<span></span>
</td>
<td class="nump">561,418<span></span>
</td>
<td class="nump">572,385<span></span>
</td>
<td class="nump">532,952<span></span>
</td>
<td class="nump">521,832<span></span>
</td>
<td class="nump">484,625<span></span>
</td>
<td class="nump">491,811<span></span>
</td>
<td class="nump">2,337,734<span></span>
</td>
<td class="nump">2,031,220<span></span>
</td>
<td class="nump">1,753,505<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_PracticeSuppliesAndOtherOperatingExpenses', window );">Practice supplies and other operating expenses</a></td>
<td class="nump">32,353<span></span>
</td>
<td class="nump">29,497<span></span>
</td>
<td class="nump">30,872<span></span>
</td>
<td class="nump">27,796<span></span>
</td>
<td class="nump">32,737<span></span>
</td>
<td class="nump">31,641<span></span>
</td>
<td class="nump">26,992<span></span>
</td>
<td class="nump">27,046<span></span>
</td>
<td class="nump">120,518<span></span>
</td>
<td class="nump">118,416<span></span>
</td>
<td class="nump">98,480<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_GeneralAndAdministrativeExpense', window );">General and administrative expenses</a></td>
<td class="nump">108,895<span></span>
</td>
<td class="nump">101,430<span></span>
</td>
<td class="nump">103,015<span></span>
</td>
<td class="nump">103,765<span></span>
</td>
<td class="nump">97,049<span></span>
</td>
<td class="nump">93,457<span></span>
</td>
<td class="nump">92,116<span></span>
</td>
<td class="nump">89,950<span></span>
</td>
<td class="nump">417,105<span></span>
</td>
<td class="nump">372,572<span></span>
</td>
<td class="nump">305,915<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DepreciationDepletionAndAmortization', window );">Depreciation and amortization</a></td>
<td class="nump">26,414<span></span>
</td>
<td class="nump">25,116<span></span>
</td>
<td class="nump">25,735<span></span>
</td>
<td class="nump">25,614<span></span>
</td>
<td class="nump">25,254<span></span>
</td>
<td class="nump">24,185<span></span>
</td>
<td class="nump">20,241<span></span>
</td>
<td class="nump">19,584<span></span>
</td>
<td class="nump">102,879<span></span>
</td>
<td class="nump">89,264<span></span>
</td>
<td class="nump">64,228<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingExpenses', window );">Total operating expenses</a></td>
<td class="nump">785,117<span></span>
</td>
<td class="nump">742,519<span></span>
</td>
<td class="nump">721,040<span></span>
</td>
<td class="nump">729,560<span></span>
</td>
<td class="nump">687,992<span></span>
</td>
<td class="nump">671,115<span></span>
</td>
<td class="nump">623,974<span></span>
</td>
<td class="nump">628,391<span></span>
</td>
<td class="nump">2,978,236<span></span>
</td>
<td class="nump">2,611,472<span></span>
</td>
<td class="nump">2,222,128<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingIncomeLoss', window );">Income from operations</a></td>
<td class="nump">125,703<span></span>
</td>
<td class="nump">126,432<span></span>
</td>
<td class="nump">121,904<span></span>
</td>
<td class="nump">106,037<span></span>
</td>
<td class="nump">142,778<span></span>
</td>
<td class="nump">156,891<span></span>
</td>
<td class="nump">147,785<span></span>
</td>
<td class="nump">124,233<span></span>
</td>
<td class="nump">480,076<span></span>
</td>
<td class="nump">571,687<span></span>
</td>
<td class="nump">557,868<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InvestmentIncomeNet', window );">Investment and other income</a></td>
<td class="nump">2,777<span></span>
</td>
<td class="nump">235<span></span>
</td>
<td class="nump">365<span></span>
</td>
<td class="nump">576<span></span>
</td>
<td class="nump">770<span></span>
</td>
<td class="nump">221<span></span>
</td>
<td class="nump">410<span></span>
</td>
<td class="nump">618<span></span>
</td>
<td class="nump">3,953<span></span>
</td>
<td class="nump">2,019<span></span>
</td>
<td class="nump">1,844<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InterestExpense', window );">Interest expense</a></td>
<td class="num">(19,844)<span></span>
</td>
<td class="num">(18,428)<span></span>
</td>
<td class="num">(18,535)<span></span>
</td>
<td class="num">(17,752)<span></span>
</td>
<td class="num">(16,356)<span></span>
</td>
<td class="num">(17,215)<span></span>
</td>
<td class="num">(15,058)<span></span>
</td>
<td class="num">(14,463)<span></span>
</td>
<td class="num">(74,559)<span></span>
</td>
<td class="num">(63,092)<span></span>
</td>
<td class="num">(23,110)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeLossFromEquityMethodInvestments', window );">Equity in earnings of unconsolidated affiliates</a></td>
<td class="num">(294)<span></span>
</td>
<td class="num">(240)<span></span>
</td>
<td class="nump">689<span></span>
</td>
<td class="nump">797<span></span>
</td>
<td class="nump">806<span></span>
</td>
<td class="nump">796<span></span>
</td>
<td class="nump">789<span></span>
</td>
<td class="nump">794<span></span>
</td>
<td class="nump">952<span></span>
</td>
<td class="nump">3,185<span></span>
</td>
<td class="nump">3,127<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NonoperatingIncomeExpense', window );">Total non-operating expenses</a></td>
<td class="num">(17,361)<span></span>
</td>
<td class="num">(18,433)<span></span>
</td>
<td class="num">(17,481)<span></span>
</td>
<td class="num">(16,379)<span></span>
</td>
<td class="num">(14,780)<span></span>
</td>
<td class="num">(16,198)<span></span>
</td>
<td class="num">(13,859)<span></span>
</td>
<td class="num">(13,051)<span></span>
</td>
<td class="num">(69,654)<span></span>
</td>
<td class="num">(57,888)<span></span>
</td>
<td class="num">(18,139)<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest', window );">Income before income taxes</a></td>
<td class="nump">108,342<span></span>
</td>
<td class="nump">107,999<span></span>
</td>
<td class="nump">104,423<span></span>
</td>
<td class="nump">89,658<span></span>
</td>
<td class="nump">127,998<span></span>
</td>
<td class="nump">140,693<span></span>
</td>
<td class="nump">133,926<span></span>
</td>
<td class="nump">111,182<span></span>
</td>
<td class="nump">410,422<span></span>
</td>
<td class="nump">513,799<span></span>
</td>
<td class="nump">539,729<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxExpenseBenefit', window );">Income tax provision</a></td>
<td class="nump">27,761<span></span>
</td>
<td class="num">(42,119)<span></span>
</td>
<td class="num">(40,725)<span></span>
</td>
<td class="num">(34,967)<span></span>
</td>
<td class="num">(49,919)<span></span>
</td>
<td class="num">(44,272)<span></span>
</td>
<td class="num">(51,601)<span></span>
</td>
<td class="num">(43,411)<span></span>
</td>
<td class="num">(90,050)<span></span>
</td>
<td class="num">(189,203)<span></span>
</td>
<td class="num">(204,038)<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProfitLoss', window );">Net income</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">78,079<span></span>
</td>
<td class="nump">96,421<span></span>
</td>
<td class="nump">82,325<span></span>
</td>
<td class="nump">67,771<span></span>
</td>
<td class="nump">320,372<span></span>
</td>
<td class="nump">324,596<span></span>
</td>
<td class="nump">335,691<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NetIncomeLossAttributableToNoncontrollingInterest', window );">Net loss attributable to noncontrolling interests</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">88<span></span>
</td>
<td class="nump">102<span></span>
</td>
<td class="nump">128<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">318<span></span>
</td>
<td class="nump">629<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NetIncomeLoss', window );">Net income attributable to MEDNAX, Inc.</a></td>
<td class="nump">$ 136,103<span></span>
</td>
<td class="nump">$ 65,880<span></span>
</td>
<td class="nump">$ 63,698<span></span>
</td>
<td class="nump">$ 54,691<span></span>
</td>
<td class="nump">$ 78,079<span></span>
</td>
<td class="nump">$ 96,509<span></span>
</td>
<td class="nump">$ 82,427<span></span>
</td>
<td class="nump">$ 67,899<span></span>
</td>
<td class="nump">$ 320,372<span></span>
</td>
<td class="nump">$ 324,914<span></span>
</td>
<td class="nump">$ 336,320<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerShareAbstract', window );"><strong>Net income attributable to MEDNAX, Inc.:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerShareBasic', window );">Earnings per share, Basic</a></td>
<td class="nump">$ 1.47<span></span>
</td>
<td class="nump">$ 0.71<span></span>
</td>
<td class="nump">$ 0.69<span></span>
</td>
<td class="nump">$ 0.59<span></span>
</td>
<td class="nump">$ 0.84<span></span>
</td>
<td class="nump">$ 1.04<span></span>
</td>
<td class="nump">$ 0.89<span></span>
</td>
<td class="nump">$ 0.74<span></span>
</td>
<td class="nump">$ 3.47<span></span>
</td>
<td class="nump">$ 3.52<span></span>
</td>
<td class="nump">$ 3.61<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerShareDiluted', window );">Earnings per share, Diluted</a></td>
<td class="nump">$ 1.46<span></span>
</td>
<td class="nump">$ 0.71<span></span>
</td>
<td class="nump">$ 0.69<span></span>
</td>
<td class="nump">$ 0.59<span></span>
</td>
<td class="nump">$ 0.84<span></span>
</td>
<td class="nump">$ 1.04<span></span>
</td>
<td class="nump">$ 0.89<span></span>
</td>
<td class="nump">$ 0.73<span></span>
</td>
<td class="nump">$ 3.45<span></span>
</td>
<td class="nump">$ 3.49<span></span>
</td>
<td class="nump">$ 3.58<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract', window );"><strong>Weighted average common shares:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_WeightedAverageNumberOfSharesOutstandingBasic', window );">Basic</a></td>
<td class="nump">92,756<span></span>
</td>
<td class="nump">92,589<span></span>
</td>
<td class="nump">92,181<span></span>
</td>
<td class="nump">92,360<span></span>
</td>
<td class="nump">92,728<span></span>
</td>
<td class="nump">92,604<span></span>
</td>
<td class="nump">92,182<span></span>
</td>
<td class="nump">92,269<span></span>
</td>
<td class="nump">92,431<span></span>
</td>
<td class="nump">92,422<span></span>
</td>
<td class="nump">93,077<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding', window );">Diluted</a></td>
<td class="nump">93,159<span></span>
</td>
<td class="nump">92,881<span></span>
</td>
<td class="nump">92,812<span></span>
</td>
<td class="nump">93,143<span></span>
</td>
<td class="nump">93,347<span></span>
</td>
<td class="nump">93,146<span></span>
</td>
<td class="nump">92,945<span></span>
</td>
<td class="nump">93,091<span></span>
</td>
<td class="nump">92,958<span></span>
</td>
<td class="nump">93,109<span></span>
</td>
<td class="nump">93,960<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_PracticeSalariesAndBenefits">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Practice salaries and benefits.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_PracticeSalariesAndBenefits</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_PracticeSuppliesAndOtherOperatingExpenses">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate amount of supplies and other operating expenses directly attributable to the physician practices.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_PracticeSuppliesAndOtherOperatingExpenses</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DepreciationDepletionAndAmortization">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate expense recognized in the current period that allocates the cost of tangible assets, intangible assets, or depleting assets to periods that benefit from use of the assets.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DepreciationDepletionAndAmortization</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EarningsPerShareAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EarningsPerShareAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EarningsPerShareBasic">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3550-109257<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 55<br> -Paragraph 52<br> -URI http://asc.fasb.org/extlink&amp;oid=96948231&amp;loc=d3e4984-109258<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-04(19))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879464&amp;loc=d3e573970-122913<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=96947427&amp;loc=d3e1252-109256<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03(21))<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br><br>Reference 6: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04(23))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879574&amp;loc=d3e536633-122882<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EarningsPerShareBasic</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EarningsPerShareDiluted">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-04(19))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879464&amp;loc=d3e573970-122913<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=96947427&amp;loc=d3e1252-109256<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03(21))<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04(23))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879574&amp;loc=d3e536633-122882<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EarningsPerShareDiluted</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_GeneralAndAdministrativeExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate total of expenses of managing and administering the affairs of an entity, including affiliates of the reporting entity, which are not directly or indirectly associated with the manufacture, sale or creation of a product or product line.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03.4)<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_GeneralAndAdministrativeExpense</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_HealthCareOrganizationRevenue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of revenues recognized by the entity from providing services to in-patients, outpatients, residents in facilities owned or operated by the entity, from insurance premiums, or from goods provided or services performed.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03.1)<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_HealthCareOrganizationRevenue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of income (loss) from continuing operations, including income (loss) from equity method investments, before deduction of income tax expense (benefit), and income (loss) attributable to noncontrolling interest.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 940<br> -SubTopic 20<br> -Section 25<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=68072869&amp;loc=d3e41242-110953<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03(10))<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04(15))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879574&amp;loc=d3e536633-122882<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-04(8))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879464&amp;loc=d3e573970-122913<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeLossFromEquityMethodInvestments">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>This item represents the entity's proportionate share for the period of the net income (loss) of its investee (such as unconsolidated subsidiaries and joint ventures) to which the equity method of accounting is applied. This item includes income or expense related to stock-based compensation based on the investor's grant of stock to employees of an equity method investee.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03(12))<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-04(10))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879464&amp;loc=d3e573970-122913<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 323<br> -SubTopic 10<br> -Section 45<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=66022249&amp;loc=d3e33749-111570<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04(13)(f))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879574&amp;loc=d3e536633-122882<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeLossFromEquityMethodInvestments</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeStatementAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeStatementAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxExpenseBenefit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (a),(b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.4-08.(h))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxExpenseBenefit</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_InterestExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of the cost of borrowed funds accounted for as interest expense.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 835<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6450988&amp;loc=d3e26243-108391<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 835<br> -SubTopic 30<br> -Section 45<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=64930785&amp;loc=d3e28555-108399<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04.9)<br> -URI http://asc.fasb.org/extlink&amp;oid=6879574&amp;loc=d3e536633-122882<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_InterestExpense</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_InvestmentIncomeNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after accretion (amortization) of discount (premium), and investment expense, of interest income and dividend income on nonoperating securities.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03.8)<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03.7(a),(b))<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03.9)<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_InvestmentIncomeNet</td>
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<tr>
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<tr>
<td><strong> Data Type:</strong></td>
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<tr>
<td><strong> Balance Type:</strong></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NetIncomeLoss">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3550-109257<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04(22))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879574&amp;loc=d3e536633-122882<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-04(18))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879464&amp;loc=d3e573970-122913<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03(20))<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NetIncomeLoss</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<tr>
<td><strong> Balance Type:</strong></td>
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<tr>
<td><strong> Period Type:</strong></td>
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</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NetIncomeLossAttributableToNoncontrollingInterest">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of Net Income (Loss) attributable to noncontrolling interest.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 55<br> -Paragraph 4J<br> -URI http://asc.fasb.org/extlink&amp;oid=84234705&amp;loc=SL4591551-111686<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1A<br> -Subparagraph (a)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161450&amp;loc=SL4573702-111684<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NetIncomeLossAttributableToNoncontrollingInterest</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NonoperatingIncomeExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate amount of income or expense from ancillary business-related activities (that is to say, excluding major activities considered part of the normal operations of the business).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03.7)<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NonoperatingIncomeExpense</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Balance Type:</strong></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingExpenses">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Generally recurring costs associated with normal operations except for the portion of these expenses which can be clearly related to production and included in cost of sales or services. Includes selling, general and administrative expense.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingExpenses</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingExpensesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingExpensesAbstract</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
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<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingIncomeLoss">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The net result for the period of deducting operating expenses from operating revenues.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingIncomeLoss</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProfitLoss">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 55<br> -Paragraph 4K<br> -URI http://asc.fasb.org/extlink&amp;oid=84234705&amp;loc=SL4591552-111686<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 45<br> -Paragraph 19<br> -URI http://asc.fasb.org/extlink&amp;oid=96868048&amp;loc=SL4569616-111683<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1A<br> -Subparagraph (c)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161450&amp;loc=SL4573702-111684<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 55<br> -Paragraph 4J<br> -URI http://asc.fasb.org/extlink&amp;oid=84234705&amp;loc=SL4591551-111686<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1A<br> -Subparagraph (a)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161450&amp;loc=SL4573702-111684<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProfitLoss</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
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</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The average number of shares or units issued and outstanding that are used in calculating diluted EPS or earnings per unit (EPU), determined based on the timing of issuance of shares or units in the period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 45<br> -Paragraph 16<br> -URI http://asc.fasb.org/extlink&amp;oid=96947427&amp;loc=d3e1505-109256<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3550-109257<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_WeightedAverageNumberOfSharesOutstandingBasic">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of [basic] shares or units, after adjustment for contingently issuable shares or units and other shares or units not deemed outstanding, determined by relating the portion of time within a reporting period that common shares or units have been outstanding to the total time in that period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3550-109257<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 45<br> -Paragraph 10<br> -URI http://asc.fasb.org/extlink&amp;oid=96947427&amp;loc=d3e1448-109256<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_WeightedAverageNumberOfSharesOutstandingBasic</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td>na</td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6779821760">
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<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Consolidated Statements of Equity - USD ($)<br> shares in Thousands</strong></div></th>
<th class="th"><div>Total</div></th>
<th class="th"><div>Common Stock [Member]</div></th>
<th class="th"><div>Additional Paid-in Capital [Member]</div></th>
<th class="th"><div>Retained Earnings [Member]</div></th>
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<td class="nump">$ 2,265,566,000<span></span>
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<td class="nump">$ 960,000<span></span>
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<td class="nump">$ 886,877,000<span></span>
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<td class="nump">$ 1,376,782,000<span></span>
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<td class="nump">$ 947,000<span></span>
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<td class="text">&#160;<span></span>
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<td class="nump">96,030<span></span>
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<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
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<td class="text">&#160;<span></span>
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</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProfitLoss', window );">Net income (loss)</a></td>
<td class="nump">335,691,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">336,320,000<span></span>
</td>
<td class="num">(629,000)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation', window );">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan</a></td>
<td class="nump">20,128,000<span></span>
</td>
<td class="nump">$ 5,000<span></span>
</td>
<td class="nump">20,123,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation', window );">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">463<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_StockIssuedDuringPeriodValueRestrictedStockAndVestingOfDeferredStock', window );">Issuance of restricted stock and vesting of deferred stock</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 5,000<span></span>
</td>
<td class="num">(5,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_StockIssuedDuringPeriodSharesRestrictedStockAndVestingOfDeferredStock', window );">Issuance of restricted stock and vesting of deferred stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">527<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration', window );">Issuance of restricted stock for acquisition consideration</a></td>
<td class="nump">7,800,000<span></span>
</td>
<td class="nump">$ 1,000<span></span>
</td>
<td class="nump">7,799,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration', window );">Issuance of restricted stock for acquisition consideration, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">114<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue', window );">Stock-based compensation expense</a></td>
<td class="nump">32,129,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">32,129,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited', window );">Forfeitures of restricted stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(30)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodValue', window );">Repurchased common stock</a></td>
<td class="num">(235,051,000)<span></span>
</td>
<td class="num">$ (34,000)<span></span>
</td>
<td class="num">(32,271,000)<span></span>
</td>
<td class="num">(202,746,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodShares', window );">Repurchased common stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(3,365)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation', window );">Excess tax benefit related to employee stock incentive plans</a></td>
<td class="nump">11,583,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">11,583,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rc">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest', window );">Balance at Dec. 31, 2015</a></td>
<td class="nump">2,437,846,000<span></span>
</td>
<td class="nump">$ 937,000<span></span>
</td>
<td class="nump">926,235,000<span></span>
</td>
<td class="nump">1,510,356,000<span></span>
</td>
<td class="nump">318,000<span></span>
</td>
</tr>
<tr class="rc">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharesIssued', window );">Balance, Shares at Dec. 31, 2015</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">93,739<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProfitLoss', window );">Net income (loss)</a></td>
<td class="nump">324,596,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">324,914,000<span></span>
</td>
<td class="num">$ (318,000)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation', window );">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan</a></td>
<td class="nump">22,022,000<span></span>
</td>
<td class="nump">$ 5,000<span></span>
</td>
<td class="nump">22,017,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation', window );">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">473<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross', window );">Issuance of restricted stock</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 5,000<span></span>
</td>
<td class="num">(5,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross', window );">Issuance of restricted stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">505<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue', window );">Stock-based compensation expense</a></td>
<td class="nump">34,000,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">34,000,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures', window );">Forfeitures of restricted stock</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">$ (1,000)<span></span>
</td>
<td class="nump">1,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited', window );">Forfeitures of restricted stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(53)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodValue', window );">Repurchased common stock</a></td>
<td class="num">(61,828,000)<span></span>
</td>
<td class="num">$ (9,000)<span></span>
</td>
<td class="num">(12,075,000)<span></span>
</td>
<td class="num">(49,744,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodShares', window );">Repurchased common stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(946)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation', window );">Excess tax benefit related to employee stock incentive plans</a></td>
<td class="nump">4,131,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">4,131,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rc">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest', window );">Balance at Dec. 31, 2016</a></td>
<td class="nump">2,760,767,000<span></span>
</td>
<td class="nump">$ 937,000<span></span>
</td>
<td class="nump">974,304,000<span></span>
</td>
<td class="nump">1,785,526,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rc">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharesIssued', window );">Balance, Shares at Dec. 31, 2016</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">93,718<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProfitLoss', window );">Net income (loss)</a></td>
<td class="nump">320,372,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">320,372,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation', window );">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan</a></td>
<td class="nump">23,276,000<span></span>
</td>
<td class="nump">$ 5,000<span></span>
</td>
<td class="nump">23,271,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation', window );">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">528<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross', window );">Issuance of restricted stock</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 5,000<span></span>
</td>
<td class="num">(5,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross', window );">Issuance of restricted stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">536<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration', window );">Issuance of restricted stock for acquisition consideration</a></td>
<td class="nump">2,658,000<span></span>
</td>
<td class="nump">$ 1,000<span></span>
</td>
<td class="nump">2,657,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration', window );">Issuance of restricted stock for acquisition consideration, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">69<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue', window );">Stock-based compensation expense</a></td>
<td class="nump">29,573,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">29,573,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures', window );">Forfeitures of restricted stock</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">$ (1,000)<span></span>
</td>
<td class="nump">1,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited', window );">Forfeitures of restricted stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(92)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodValue', window );">Repurchased common stock</a></td>
<td class="num">(70,192,000)<span></span>
</td>
<td class="num">$ (10,000)<span></span>
</td>
<td class="num">(12,473,000)<span></span>
</td>
<td class="num">(57,709,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodShares', window );">Repurchased common stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(1,038)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation', window );">Excess tax benefit related to employee stock incentive plans</a></td>
<td class="nump">0<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rc">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest', window );">Balance at Dec. 31, 2017</a></td>
<td class="nump">$ 3,066,454,000<span></span>
</td>
<td class="nump">$ 937,000<span></span>
</td>
<td class="nump">$ 1,017,328,000<span></span>
</td>
<td class="nump">$ 2,048,189,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rc">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharesIssued', window );">Balance, Shares at Dec. 31, 2017</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">93,721<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Stock issued during period shares restricted stock acquisition consideration.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_StockIssuedDuringPeriodSharesRestrictedStockAndVestingOfDeferredStock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Stock issued during period shares restricted stock and vesting of deferred stock.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_StockIssuedDuringPeriodSharesRestrictedStockAndVestingOfDeferredStock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Stock issued during period value restricted stock acquisition consideration.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_StockIssuedDuringPeriodValueRestrictedStockAndVestingOfDeferredStock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Stock issued during period value restricted stock and vesting of deferred stock.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_StockIssuedDuringPeriodValueRestrictedStockAndVestingOfDeferredStock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase to additional paid-in capital (APIC) from recognition of equity-based compensation.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 35<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=79507207&amp;loc=d3e4534-113899<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5047-113901<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 20<br> -Section 55<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=96864182&amp;loc=d3e11149-113907<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 20<br> -Section 55<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=96864182&amp;loc=d3e11178-113907<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase in additional paid in capital (APIC) resulting from a tax benefit associated with share-based compensation plan other than an employee stock ownership plan (ESOP). Includes, but is not limited to, excess tax benefit.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 740<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=79981250&amp;loc=d3e23524-113945<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.3-04)<br> -URI http://asc.fasb.org/extlink&amp;oid=27012166&amp;loc=d3e187085-122770<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84159872&amp;loc=d3e21463-112644<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProfitLoss">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 55<br> -Paragraph 4K<br> -URI http://asc.fasb.org/extlink&amp;oid=84234705&amp;loc=SL4591552-111686<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 45<br> -Paragraph 19<br> -URI http://asc.fasb.org/extlink&amp;oid=96868048&amp;loc=SL4569616-111683<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1A<br> -Subparagraph (c)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161450&amp;loc=SL4573702-111684<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 55<br> -Paragraph 4J<br> -URI http://asc.fasb.org/extlink&amp;oid=84234705&amp;loc=SL4591551-111686<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1A<br> -Subparagraph (a)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161450&amp;loc=SL4573702-111684<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProfitLoss</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_SharesIssued">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of shares of stock issued as of the balance sheet date, including shares that had been issued and were previously outstanding but which are now held in the treasury.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84159872&amp;loc=d3e21463-112644<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SharesIssued</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of shares related to Restricted Stock Award forfeited during the period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84159872&amp;loc=d3e21463-112644<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(28))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.3-04)<br> -URI http://asc.fasb.org/extlink&amp;oid=27012166&amp;loc=d3e187085-122770<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of shares (or other type of equity) issued during the period as a result of any equity-based compensation plan other than an employee stock ownership plan (ESOP), net of any shares forfeited. Shares issued could result from the issuance of restricted stock, the exercise of stock options, stock issued under employee stock purchase plans, and/or other employee benefit plans.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(28))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84159872&amp;loc=d3e21463-112644<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.3-04)<br> -URI http://asc.fasb.org/extlink&amp;oid=27012166&amp;loc=d3e187085-122770<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Gross number of shares (or other type of equity) issued during the period as a result of any equity-based compensation plan other than an employee stock ownership plan (ESOP). Shares issued could result from the issuance of restricted stock, the exercise of stock options, stock issued under employee stock purchase plans, and/or other employee benefit plans.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures">
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Value of stock related to Restricted Stock Awards forfeited during the period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84159872&amp;loc=d3e21463-112644<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(28))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.3-04)<br> -URI http://asc.fasb.org/extlink&amp;oid=27012166&amp;loc=d3e187085-122770<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<td><strong> Period Type:</strong></td>
<td>duration</td>
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</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Value of stock (or other type of equity) issued during the period as a result of any equity-based compensation plan other than an employee stock ownership plan (ESOP), net of stock value of such awards forfeited. Stock issued could result from the issuance of restricted stock, the exercise of stock options, stock issued under employee stock purchase plans, and/or other employee benefit plans.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5047-113901<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (d)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.3-04)<br> -URI http://asc.fasb.org/extlink&amp;oid=27012166&amp;loc=d3e187085-122770<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(28))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Gross value of stock (or other type of equity) issued during the period as a result of any equity-based compensation plan other than an employee stock ownership plan (ESOP). Stock issued could result from the issuance of restricted stock, the exercise of stock options, stock issued under employee stock purchase plans, and/or other employee benefit plans.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<td><strong> Balance Type:</strong></td>
<td>credit</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of shares that have been repurchased during the period and have not been retired and are not held in treasury. Some state laws may govern the circumstances under which an entity may acquire its own stock and prescribe the accounting treatment therefore. This element is used when state law does not recognize treasury stock.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(28))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.3-04)<br> -URI http://asc.fasb.org/extlink&amp;oid=27012166&amp;loc=d3e187085-122770<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84159872&amp;loc=d3e21463-112644<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockRepurchasedDuringPeriodShares</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockRepurchasedDuringPeriodValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Equity impact of the value of stock that has been repurchased during the period and has not been retired and is not held in treasury. Some state laws may mandate the circumstances under which an entity may acquire its own stock and prescribe the accounting treatment therefore. This element is used when state law does not recognize treasury stock.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.3-04)<br> -URI http://asc.fasb.org/extlink&amp;oid=27012166&amp;loc=d3e187085-122770<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84159872&amp;loc=d3e21463-112644<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(28))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockRepurchasedDuringPeriodValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of stockholders' equity (deficit), net of receivables from officers, directors, owners, and affiliates of the entity, attributable to both the parent and noncontrolling interests. Amount excludes temporary equity. Alternate caption for the concept is permanent equity.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 55<br> -Paragraph 4I<br> -URI http://asc.fasb.org/extlink&amp;oid=84234705&amp;loc=SL4590271-111686<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 45<br> -Paragraph 16<br> -URI http://asc.fasb.org/extlink&amp;oid=96868048&amp;loc=SL4568740-111683<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 45<br> -Paragraph 15<br> -URI http://asc.fasb.org/extlink&amp;oid=96868048&amp;loc=SL4568447-111683<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StatementEquityComponentsAxis=us-gaap_CommonStockMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StatementEquityComponentsAxis=us-gaap_CommonStockMember</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Data Type:</strong></td>
<td>na</td>
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<td><strong> Period Type:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
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<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StatementEquityComponentsAxis=us-gaap_AdditionalPaidInCapitalMember</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
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<td><strong> Data Type:</strong></td>
<td>na</td>
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<td><strong> Balance Type:</strong></td>
<td></td>
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<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StatementEquityComponentsAxis=us-gaap_RetainedEarningsMember</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
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<td><strong> Data Type:</strong></td>
<td>na</td>
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<td><strong> Balance Type:</strong></td>
<td></td>
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<td><strong> Period Type:</strong></td>
<td></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StatementEquityComponentsAxis=us-gaap_NoncontrollingInterestMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
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<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StatementEquityComponentsAxis=us-gaap_NoncontrollingInterestMember</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
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<td><strong> Data Type:</strong></td>
<td>na</td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6779735840">
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<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Consolidated Statements of Cash Flows - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NetCashProvidedByUsedInOperatingActivitiesContinuingOperationsAbstract', window );"><strong>Cash flows from operating activities:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProfitLoss', window );">Net income</a></td>
<td class="nump">$ 320,372<span></span>
</td>
<td class="nump">$ 324,596<span></span>
</td>
<td class="nump">$ 335,691<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract', window );"><strong>Adjustments to reconcile net income to net cash provided from operating activities:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DepreciationDepletionAndAmortization', window );">Depreciation and amortization</a></td>
<td class="nump">102,879<span></span>
</td>
<td class="nump">89,264<span></span>
</td>
<td class="nump">64,228<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AmortizationOfFinancingCostsAndDiscounts', window );">Amortization of premiums, discounts and issuance costs</a></td>
<td class="nump">5,514<span></span>
</td>
<td class="nump">4,816<span></span>
</td>
<td class="nump">1,541<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensation', window );">Stock-based compensation expense</a></td>
<td class="nump">29,573<span></span>
</td>
<td class="nump">34,000<span></span>
</td>
<td class="nump">32,129<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredIncomeTaxExpenseBenefit', window );">Deferred income taxes</a></td>
<td class="num">(60,073)<span></span>
</td>
<td class="nump">18,149<span></span>
</td>
<td class="nump">14,494<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OtherNoncashIncomeExpense', window );">Other</a></td>
<td class="num">(3,783)<span></span>
</td>
<td class="nump">212<span></span>
</td>
<td class="num">(1,052)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncreaseDecreaseInOperatingCapitalAbstract', window );"><strong>Changes in assets and liabilities:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncreaseDecreaseInAccountsReceivable', window );">Accounts receivable</a></td>
<td class="nump">7,803<span></span>
</td>
<td class="num">(34,000)<span></span>
</td>
<td class="num">(55,391)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets', window );">Prepaid expenses and other current assets</a></td>
<td class="num">(2,792)<span></span>
</td>
<td class="num">(783)<span></span>
</td>
<td class="num">(4,905)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncreaseDecreaseInOtherNoncurrentAssets', window );">Other long-term assets</a></td>
<td class="num">(2,709)<span></span>
</td>
<td class="nump">10,035<span></span>
</td>
<td class="nump">98<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities', window );">Accounts payable and accrued expenses</a></td>
<td class="nump">24,551<span></span>
</td>
<td class="nump">11,617<span></span>
</td>
<td class="num">(7,874)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncreaseDecreaseInAccruedIncomeTaxesPayable', window );">Income taxes payable</a></td>
<td class="nump">73,050<span></span>
</td>
<td class="num">(2,234)<span></span>
</td>
<td class="num">(4,101)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PaymentForContingentConsiderationLiabilityOperatingActivities', window );">Payments of contingent consideration liabilities</a></td>
<td class="num">(750)<span></span>
</td>
<td class="num">(1,037)<span></span>
</td>
<td class="num">(1,439)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyPeriodIncreaseDecrease', window );">Long-term professional liabilities</a></td>
<td class="nump">18,478<span></span>
</td>
<td class="num">(3,452)<span></span>
</td>
<td class="num">(2,064)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncreaseDecreaseInOtherOperatingLiabilities', window );">Other liabilities</a></td>
<td class="num">(735)<span></span>
</td>
<td class="num">(7,405)<span></span>
</td>
<td class="num">(2,654)<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NetCashProvidedByUsedInOperatingActivitiesContinuingOperations', window );">Net cash provided from operating activities</a></td>
<td class="nump">511,378<span></span>
</td>
<td class="nump">443,778<span></span>
</td>
<td class="nump">368,701<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperationsAbstract', window );"><strong>Cash flows from investing activities:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired', window );">Acquisition payments, net of cash acquired</a></td>
<td class="num">(531,696)<span></span>
</td>
<td class="num">(762,302)<span></span>
</td>
<td class="num">(818,903)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PaymentsToAcquireInvestments', window );">Purchases of investments</a></td>
<td class="num">(27,723)<span></span>
</td>
<td class="num">(60,976)<span></span>
</td>
<td class="num">(33,980)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProceedsFromSaleMaturityAndCollectionsOfInvestments', window );">Proceeds from maturities of investments</a></td>
<td class="nump">25,410<span></span>
</td>
<td class="nump">41,325<span></span>
</td>
<td class="nump">31,956<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PaymentsToAcquireOtherPropertyPlantAndEquipment', window );">Purchases of property and equipment</a></td>
<td class="num">(49,309)<span></span>
</td>
<td class="num">(39,264)<span></span>
</td>
<td class="num">(27,073)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PaymentsForProceedsFromOtherInvestingActivities', window );">Other</a></td>
<td class="nump">6,705<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperations', window );">Net cash used in investing activities</a></td>
<td class="num">(576,613)<span></span>
</td>
<td class="num">(821,217)<span></span>
</td>
<td class="num">(848,000)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperationsAbstract', window );"><strong>Cash flows from financing activities:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProceedsFromLinesOfCredit', window );">Borrowings on credit agreement</a></td>
<td class="nump">2,846,000<span></span>
</td>
<td class="nump">1,940,000<span></span>
</td>
<td class="nump">2,121,500<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RepaymentsOfLinesOfCredit', window );">Payments on credit agreement</a></td>
<td class="num">(2,699,000)<span></span>
</td>
<td class="num">(1,510,000)<span></span>
</td>
<td class="num">(2,156,000)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt', window );">Proceeds from issuance of senior notes</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">750,000<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PaymentsOfFinancingCosts', window );">Payments for financing costs</a></td>
<td class="num">(3,525)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(14,190)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PaymentForContingentConsiderationLiabilityFinancingActivities', window );">Payments of contingent consideration liabilities</a></td>
<td class="num">(5,449)<span></span>
</td>
<td class="num">(10,740)<span></span>
</td>
<td class="num">(12,856)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RepaymentsOfLongTermCapitalLeaseObligations', window );">Payments on capital lease obligations</a></td>
<td class="num">(2,267)<span></span>
</td>
<td class="num">(2,130)<span></span>
</td>
<td class="num">(2,171)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities', window );">Excess tax benefit from exercises of stock options and vesting of restricted and deferred stock</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">4,241<span></span>
</td>
<td class="nump">11,583<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProceedsFromIssuanceOfCommonStock', window );">Proceeds from issuance of common stock</a></td>
<td class="nump">23,276<span></span>
</td>
<td class="nump">22,022<span></span>
</td>
<td class="nump">20,128<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProceedsFromMinorityShareholders', window );">Contribution from noncontrolling interests</a></td>
<td class="nump">894<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PaymentsForRepurchaseOfCommonStock', window );">Repurchases of common stock</a></td>
<td class="num">(70,192)<span></span>
</td>
<td class="num">(61,828)<span></span>
</td>
<td class="num">(235,051)<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperations', window );">Net cash provided from financing activities</a></td>
<td class="nump">89,737<span></span>
</td>
<td class="nump">381,565<span></span>
</td>
<td class="nump">482,943<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease', window );">Net increase in cash and cash equivalents</a></td>
<td class="nump">24,502<span></span>
</td>
<td class="nump">4,126<span></span>
</td>
<td class="nump">3,644<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents', window );">Cash, cash equivalents and restricted cash at beginning of year</a></td>
<td class="nump">55,698<span></span>
</td>
<td class="nump">51,572<span></span>
</td>
<td class="nump">47,928<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents', window );">Cash, cash equivalents and restricted cash at end of year</a></td>
<td class="nump">80,200<span></span>
</td>
<td class="nump">55,698<span></span>
</td>
<td class="nump">51,572<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SupplementalCashFlowInformationAbstract', window );"><strong>Supplemental disclosure of cash flow information:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InterestPaidNet', window );">Interest</a></td>
<td class="nump">73,837<span></span>
</td>
<td class="nump">60,453<span></span>
</td>
<td class="nump">20,367<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxesPaidNet', window );">Income taxes</a></td>
<td class="nump">75,427<span></span>
</td>
<td class="nump">175,962<span></span>
</td>
<td class="nump">181,005<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract', window );"><strong>Non-cash investing and financing activities:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssued1', window );">Value of common stock issued for acquisitions</a></td>
<td class="nump">2,657<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">7,800<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalLeaseObligationsIncurred', window );">Equipment financed through capital leases</a></td>
<td class="nump">684<span></span>
</td>
<td class="nump">1,619<span></span>
</td>
<td class="nump">3,135<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalExpendituresIncurredButNotYetPaid', window );">Property and equipment included in accounts payable</a></td>
<td class="nump">$ 2,700<span></span>
</td>
<td class="nump">$ 2,673<span></span>
</td>
<td class="nump">$ 1,800<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AmortizationOfFinancingCostsAndDiscounts">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of amortization expense attributable to debt discount (premium) and debt issuance costs.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AmortizationOfFinancingCostsAndDiscounts</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CapitalExpendituresIncurredButNotYetPaid">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Future cash outflow to pay for purchases of fixed assets that have occurred.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 5<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4332-108586<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4313-108586<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4304-108586<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CapitalExpendituresIncurredButNotYetPaid</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CapitalLeaseObligationsIncurred">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The increase during the period in capital lease obligations due to entering into new capital leases.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4313-108586<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4304-108586<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CapitalLeaseObligationsIncurred</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase (decrease) in cash and cash equivalents. Cash and cash equivalents are the amount of currency on hand as well as demand deposits with banks or financial institutions. Includes other kinds of accounts that have the general characteristics of demand deposits. Also includes short-term, highly liquid investments that are both readily convertible to known amounts of cash and so near their maturity that they present insignificant risk of changes in value because of changes in interest rates. Includes effect from exchange rate changes.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 24<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3521-108585<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 830<br> -SubTopic 230<br> -Section 45<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=98513438&amp;loc=d3e33268-110906<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CashAndCashEquivalentsPeriodIncreaseDecrease</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash and cash equivalents, and cash and cash equivalents restricted to withdrawal or usage. Excludes amount for disposal group and discontinued operations. Cash includes, but is not limited to, currency on hand, demand deposits with banks or financial institutions, and other accounts with general characteristics of demand deposits. Cash equivalents include, but are not limited to, short-term, highly liquid investments that are both readily convertible to known amounts of cash and so near their maturity that they present insignificant risk of changes in value because of changes in interest rates.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 24<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3521-108585<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=SL98516268-108586<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3044-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredIncomeTaxExpenseBenefit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of deferred income tax expense (benefit) pertaining to income (loss) from continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.4-08(h))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB Topic 6.I.7)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredIncomeTaxExpenseBenefit</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DepreciationDepletionAndAmortization">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate expense recognized in the current period that allocates the cost of tangible assets, intangible assets, or depleting assets to periods that benefit from use of the assets.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DepreciationDepletionAndAmortization</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash inflow from realized tax benefit related to deductible compensation cost reported on the entity's tax return for equity instruments in excess of the compensation cost for those instruments recognized for financial reporting purposes.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 20<br> -Section 55<br> -Paragraph 24<br> -URI http://asc.fasb.org/extlink&amp;oid=96864182&amp;loc=d3e11374-113907<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxesPaidNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of cash paid during the current period to foreign, federal, state, and local authorities as taxes on income, net of any cash received during the current period as refunds for the overpayment of taxes.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4297-108586<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxesPaidNet</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The increase (decrease) during the reporting period in the amounts payable to vendors for goods and services received and the amount of obligations and expenses incurred but not paid.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncreaseDecreaseInAccountsReceivable">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The increase (decrease) during the reporting period in amount due within one year (or one business cycle) from customers for the credit sale of goods and services.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncreaseDecreaseInAccountsReceivable</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncreaseDecreaseInAccruedIncomeTaxesPayable">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The increase (decrease) during the period in the amount due for taxes based on the reporting entity's earnings or attributable to the entity's income earning process (business presence) within a given jurisdiction.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncreaseDecreaseInAccruedIncomeTaxesPayable</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncreaseDecreaseInOperatingCapitalAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncreaseDecreaseInOperatingCapitalAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncreaseDecreaseInOtherNoncurrentAssets">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase (decrease) in noncurrent assets classified as other.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncreaseDecreaseInOtherNoncurrentAssets</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncreaseDecreaseInOtherOperatingLiabilities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase (decrease) in operating liabilities classified as other.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncreaseDecreaseInOtherOperatingLiabilities</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase (decrease) in prepaid expenses, and assets classified as other.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_InterestPaidNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash paid, after deduction of cash paid for capitalized interest, for interest. Includes, but is not limited to, payment to settle zero-coupon bond for accreted interest of debt discount and debt instrument with insignificant coupon interest rate in relation to effective interest rate of borrowing attributable to accreted interest of debt discount.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4297-108586<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_InterestPaidNet</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyPeriodIncreaseDecrease">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The increase (decrease) in the accrued liability for malpractice claims during an accounting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_MalpracticeLossContingencyPeriodIncreaseDecrease</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash inflow (outflow) of financing activities, excluding discontinued operations. Financing activity cash flows include obtaining resources from owners and providing them with a return on, and a return of, their investment; borrowing money and repaying amounts borrowed, or settling the obligation; and obtaining and paying for other resources obtained from creditors on long-term credit.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 26<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3574-108585<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 24<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3521-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperations</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperationsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NetCashProvidedByUsedInFinancingActivitiesContinuingOperationsAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash inflow (outflow) of investing activities, excluding discontinued operations. Investing activity cash flows include making and collecting loans and acquiring and disposing of debt or equity instruments and property, plant, and equipment and other productive assets.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 26<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3574-108585<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 24<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3521-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperations</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperationsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NetCashProvidedByUsedInInvestingActivitiesContinuingOperationsAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NetCashProvidedByUsedInOperatingActivitiesContinuingOperations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash inflow (outflow) from operating activities, excluding discontinued operations. Operating activity cash flows include transactions, adjustments, and changes in value not defined as investing or financing activities.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 24<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3521-108585<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 25<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3536-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NetCashProvidedByUsedInOperatingActivitiesContinuingOperations</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NetCashProvidedByUsedInOperatingActivitiesContinuingOperationsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NetCashProvidedByUsedInOperatingActivitiesContinuingOperationsAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OtherNoncashIncomeExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of income (expense) included in net income that results in no cash inflow (outflow), classified as other.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OtherNoncashIncomeExpense</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PaymentForContingentConsiderationLiabilityFinancingActivities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash outflow, not made soon after acquisition date of business combination, to settle contingent consideration liability up to amount recognized at acquisition date, including, but not limited to, measurement period adjustment and less amount paid soon after acquisition date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 15<br> -Subparagraph (f)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3291-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PaymentForContingentConsiderationLiabilityFinancingActivities</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PaymentForContingentConsiderationLiabilityOperatingActivities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash outflow, not made soon after acquisition date of business combination, to settle contingent consideration liability exceeding amount recognized at acquisition date. Includes, but is not limited to, measurement period adjustment and less amount paid soon after acquisition date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 17<br> -Subparagraph (ee)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3367-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PaymentForContingentConsiderationLiabilityOperatingActivities</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PaymentsForProceedsFromOtherInvestingActivities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash (inflow) outflow from investing activities classified as other.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 9<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3098-108585<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3095-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PaymentsForProceedsFromOtherInvestingActivities</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PaymentsForRepurchaseOfCommonStock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cash outflow to reacquire common stock during the period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 15<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3291-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PaymentsForRepurchaseOfCommonStock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PaymentsOfFinancingCosts">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cash outflow for loan and debt issuance costs.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 15<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3291-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PaymentsOfFinancingCosts</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cash outflow associated with the acquisition of a business, net of the cash acquired from the purchase.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 13<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3213-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PaymentsToAcquireInvestments">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cash outflow associated with the purchase of all investments (debt, security, other) during the period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3213-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PaymentsToAcquireInvestments</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PaymentsToAcquireOtherPropertyPlantAndEquipment">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash outflow from the acquisition of or improvements to long-lived, physical assets used to produce goods and services and not intended for resale, classified as other.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 13<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3213-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PaymentsToAcquireOtherPropertyPlantAndEquipment</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProceedsFromIssuanceOfCommonStock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cash inflow from the additional capital contribution to the entity.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 14<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3255-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProceedsFromIssuanceOfCommonStock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cash inflow from a borrowing with the highest claim on the assets of the entity in case of bankruptcy or liquidation (with maturities initially due after one year or beyond the operating cycle, if longer).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 14<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3255-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProceedsFromLinesOfCredit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash inflow from contractual arrangement with the lender, including but not limited to, letter of credit, standby letter of credit and revolving credit arrangements.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 14<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3255-108585<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.4-08.(f))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProceedsFromLinesOfCredit</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProceedsFromMinorityShareholders">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash inflow from a noncontrolling interest. Includes, but is not limited to, purchase of additional shares or other increase in noncontrolling interest ownership.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 14<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3255-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cash inflow associated with the sale, maturity and collection of all investments such as debt, security and so forth during the period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3179-108585<br></p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 55<br> -Paragraph 4K<br> -URI http://asc.fasb.org/extlink&amp;oid=84234705&amp;loc=SL4591552-111686<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 45<br> -Paragraph 19<br> -URI http://asc.fasb.org/extlink&amp;oid=96868048&amp;loc=SL4569616-111683<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1A<br> -Subparagraph (c)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161450&amp;loc=SL4573702-111684<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 55<br> -Paragraph 4J<br> -URI http://asc.fasb.org/extlink&amp;oid=84234705&amp;loc=SL4591551-111686<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1A<br> -Subparagraph (a)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161450&amp;loc=SL4573702-111684<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProfitLoss</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<tr>
<td><strong> Data Type:</strong></td>
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<tr>
<td><strong> Balance Type:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash outflow for payment of an obligation from a lender, including but not limited to, letter of credit, standby letter of credit and revolving credit arrangements.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 15<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3291-108585<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.4-08.(f))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RepaymentsOfLinesOfCredit</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<tr>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cash outflow for the obligation for a lease meeting the criteria for capitalization (with maturities exceeding one year or beyond the operating cycle of the entity, if longer).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 15<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3291-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
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<td><strong> Name:</strong></td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate amount of noncash, equity-based employee remuneration. This may include the value of stock or unit options, amortization of restricted stock or units, and adjustment for officers' compensation. As noncash, this element is an add back when calculating net cash generated by operating activities using the indirect method.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensation</td>
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<tr>
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<tr>
<td><strong> Data Type:</strong></td>
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<td><strong> Balance Type:</strong></td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The fair value of stock issued in noncash financing activities.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 5<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4332-108586<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4304-108586<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4313-108586<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
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<td style="white-space:nowrap;">us-gaap_StockIssued1</td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6769222976">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>General<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract', window );"><strong>Organization, Consolidation and Presentation of Financial Statements [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NatureOfOperations', window );">General</a></td>
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 <p style="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
 <b>1.&#xA0;&#xA0;&#xA0;&#xA0;General:</b></p>
 <p style="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 The principal business activity of MEDNAX, Inc.
 (&#x201C;MEDNAX&#x201D; or the &#x201C;Company&#x201D;) and its
 subsidiaries is to provide neonatal, anesthesia, radiology and
 teleradiology, maternal-fetal and other pediatric subspecialty
 physician services. The Company has contracts with affiliated
 business corporations or professional associations, limited
 liability companies and partnerships (&#x201C;affiliated
 professional contractors&#x201D;), which are separate legal entities
 that provide physician services in certain states and Puerto Rico.
 The Company and its affiliated professional contractors also have
 contracts with hospitals and other healthcare facilities to provide
 physician services, which include <font style="white-space:nowrap"><font style="white-space:nowrap">(i)&#xA0;fee-for-service</font></font>
 contracts, whereby hospitals and other customers agree, in exchange
 for the Company&#x2019;s services, to authorize the Company and its
 healthcare professionals to bill and collect the charges for
 medical services rendered by the Company&#x2019;s affiliated
 healthcare professionals, and (ii)&#xA0;administrative fee
 contracts, whereby the Company is assured a minimum revenue
 level.</p>
 <p style="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 In addition to its national physician network, the Company also
 provides services nationwide to healthcare providers, including its
 own, through complementary businesses including a management
 services organization specializing in full-service revenue cycle
 management and a consulting services company.</p>
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</tr>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for the nature of an entity's business, major products or services, principal markets including location, and the relative importance of its operations in each business and the basis for the determination, including but not limited to, assets, revenues, or earnings. For an entity that has not commenced principal operations, disclosures about the risks and uncertainties related to the activities in which the entity is currently engaged and an understanding of what those activities are being directed toward.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -URI http://asc.fasb.org/topic&amp;trid=2134479<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NatureOfOperations</td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract</td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6935895120">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Summary of Significant Accounting Policies<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccountingPoliciesAbstract', window );"><strong>Accounting Policies [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
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<tr class="ro">
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 <td valign="top" width="4%" align="left">
 <b>2.&#xA0;&#xA0;&#xA0;&#xA0;Summary</b></td>
 <td valign="top" align="left"><b>of Significant Accounting
 Policies:</b></td>
 </tr>
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 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt">
 <b>Principles of Presentation</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 The consolidated financial statements include all the accounts of
 the Company and its subsidiaries combined with the accounts of the
 affiliated professional contractors with which the Company
 currently has specific management arrangements. The Company&#x2019;s
 agreements with affiliated professional contractors provide that
 the term of the arrangements are in most cases permanent, subject
 only to termination by the Company, except in the case of gross
 negligence, fraud or bankruptcy of the Company. The Company has the
 right to receive income, both as ongoing fees and as proceeds from
 the sale of its interest in the Company&#x2019;s affiliated
 professional contractors, in an amount that fluctuates based on the
 performance of the affiliated professional contractors and the
 change in the fair value of the Company&#x2019;s interest in the
 affiliated professional contractors. The Company has exclusive
 responsibility for the provision of all <font style="WHITE-SPACE: nowrap">non-medical</font> services required for the
 <font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">day-to-day</font></font> operation and
 management of the Company&#x2019;s affiliated professional
 contractors and establishes the guidelines for the employment and
 compensation of the physicians. In addition, the agreements provide
 that the Company has the right, but not the obligation, to
 purchase, or to designate a person(s) to purchase, the stock of the
 Company&#x2019;s affiliated professional contractors for a nominal
 amount. Separately, in its sole discretion, the Company has the
 right to assign its interest in the agreements. Based upon the
 provisions of these agreements, the Company has determined that the
 affiliated professional contractors are variable interest entities
 and that the Company is the primary beneficiary as defined in the
 accounting guidance for consolidation. All significant intercompany
 and interaffiliate accounts and transactions have been
 eliminated.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 The Company is a partner in a joint venture in which it owns a
 37.5% economic interest. The Company accounts for this joint
 venture under the equity method of accounting because the Company
 exercises significant influence over, but does not control, this
 entity. On March&#xA0;31, 2017, the Company sold its 75% economic
 interest in a second joint venture. The Company had a management
 agreement with the joint venture and, based on the terms of the
 agreement, the Company had determined that the joint venture was a
 variable interest entity for which the Company was the primary
 beneficiary. Accordingly, through the date of the sale, the
 financial results of the joint venture were fully consolidated into
 the Company&#x2019;s operating results and the equity interests of
 the outside investor in the equity and results of operations of
 this consolidated entity were accounted for and presented as
 noncontrolling interests. See Note 6 for more information regarding
 the deconsolidation of this joint venture.</p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 18px">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Recently Adopted
 Accounting Pronouncements</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In January
 2017, the accounting guidance related to goodwill impairment was
 amended to remove step two of the impairment test that requires a
 hypothetical purchase price allocation in order to measure the
 amount of any impairment. Under the new guidance, only a
 single-step quantitative test is required and any goodwill
 impairment will now be the amount by which a reporting unit&#x2019;s
 carrying value exceeds its fair value. The new guidance does not
 amend the optional alternative to perform a qualitative assessment
 to determine if a quantitative goodwill impairment test is
 necessary. The Company early adopted this accounting guidance on
 December&#xA0;31, 2017 as permitted. The adoption of this guidance
 did not have an impact on the Company&#x2019;s Consolidated
 Financial Statements.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In January
 2017, the accounting guidance related to business combinations was
 amended to clarify the definition of a business. The Company early
 adopted this accounting guidance on December&#xA0;31, 2017 as
 permitted. The adoption of this guidance did not have an impact on
 the Company&#x2019;s Consolidated Financial Statements.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In August 2016
 and November 2016, the accounting guidance related to the statement
 of cash flows was amended with the intent of reducing diversity in
 practice as to the classification of certain transactions in the
 statement of cash flows. The Company early adopted this accounting
 guidance on December&#xA0;31, 2017 as permitted. The adoption of
 this guidance resulted in the inclusion of restricted cash balances
 in the Company&#x2019;s Consolidated Statements of Cash
 Flows.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In March 2016,
 the accounting guidance related to various aspects of share-based
 payment transactions was amended, including income tax
 consequences, classification of awards as either equity or
 liabilities, and classification on the statement of cash flows.
 Under the new guidance, excess tax benefits and deficiencies are to
 be recognized as income tax benefits or expenses in the income
 statement as discrete items in the reporting period in which they
 occur instead of increases or decreases to shareholders&#x2019;
 equity. Excess tax benefits should be classified along with other
 income tax cash flows as operating activities. With regard to
 forfeitures, the entity may make an entity-wide accounting policy
 election to either estimate the number of awards that are expected
 to vest or account for forfeitures when they occur. This guidance
 became effective for the Company on January&#xA0;1, 2017. The
 Company adopted this guidance prospectively for both the income
 statement and statement of cash flows, and the adoption of this
 guidance did not have a material impact on the Company&#x2019;s
 Consolidated Financial Statements. The Company continues to
 estimate forfeitures based on the number of awards that are
 expected to vest.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>New Accounting
 Pronouncements</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In February
 2016, the accounting guidance related to leases was issued that
 will require an entity to recognize leased assets and the rights
 and obligations created by those leased assets on the balance sheet
 and to disclose key information about the entity&#x2019;s leasing
 arrangements. This guidance will become effective for the Company
 on January&#xA0;1, 2019, with early adoption permitted. The Company
 expects that the adoption of this guidance will have a material
 impact on its Consolidated Balance Sheets and related disclosures,
 resulting from the recognition of significant right of use assets
 and related liabilities primarily related to its operating lease
 arrangements for space in hospitals and certain other facilities
 for its business and medical offices. The Company is in the process
 of reviewing its existing lease portfolio and accumulating all of
 the necessary information required to properly account for leases
 under the new guidance.&#xA0;Additionally, the Company is assessing
 system requirements, required changes to its processes and internal
 control implications to ensure the Company will meet the reporting
 and disclosure requirements. The Company&#x2019;s evaluation of this
 guidance and its impacts are expected to continue through the third
 quarter of 2018.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In May 2014,
 the accounting guidance related to revenue recognition was amended
 to outline a single, comprehensive model for accounting for revenue
 from contracts with customers. The core principle of the new
 accounting guidance is to require an entity to recognize as revenue
 the amount that reflects the consideration to which it expects to
 be entitled in exchange for goods or services as it transfers
 control to its customers.&#xA0;The new guidance will become
 effective for the Company on January&#xA0;1, 2018. The
 Company&#x2019;s current revenue recognition policies for its
 significant revenue streams materially comply with the amended
 guidance. The primary change for healthcare providers under the new
 guidance is the requirement to report the allowance for
 uncollectibles associated with patient responsibility amounts as a
 reduction in net revenue as opposed to bad debt expense as a
 component of operating expenses. The Company has historically
 included the allowance for uncollectibles associated with patient
 responsibility amounts with its allowance for contractual
 adjustments as a reduction in net revenue as such amounts are not
 material. Accordingly, the adoption of this guidance will not have
 an impact on our Consolidated Financial Statements.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Accounting Estimates and
 Assumptions</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The preparation
 of financial statements in conformity with accounting principles
 generally accepted in the United States (&#x201C;GAAP&#x201D;)
 requires management to make estimates and assumptions that affect
 the reported amounts of assets and liabilities and disclosure of
 contingent assets and liabilities at the date of the financial
 statements and the reported amounts of revenue and expenses during
 the reporting periods. Significant estimates and assumptions are
 involved in the calculation of the Company&#x2019;s allowance for
 contractual adjustments and uncollectibles on accounts receivable,
 liabilities for self- insured amounts and claims incurred but not
 reported related to the Company&#x2019;s professional liability
 risks and the fair value of goodwill. Actual results could differ
 from those estimates.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Segment
 Reporting</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The results of
 the Company&#x2019;s operations are aggregated into a single
 reportable segment for purposes of presenting financial information
 in accordance with the accounting guidance for segment
 reporting.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The following
 table summarizes the Company&#x2019;s net revenue by service line
 (in percentages):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="75%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Years&#xA0;Ended&#xA0;December&#xA0;31,</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2015</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Anesthesiology</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">38</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">39</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">37</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Neonatology and other
 pediatric subspecialties</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">37</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">39</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">44</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Maternal-fetal
 medicine</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">8</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">8</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">9</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Radiology and
 teleradiology</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">8</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">6</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">4</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Management
 services</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">6</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">5</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">2</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Pediatric
 cardiology</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">3</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">3</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">4</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">100</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">100</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">100</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Revenue
 Recognition</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Patient service
 revenue is recognized at the time services are provided by the
 Company&#x2019;s affiliated physicians. Almost all of the
 Company&#x2019;s patient service revenue is reimbursed by
 government-sponsored healthcare programs and third-party insurance
 payors. Payments for services rendered to the Company&#x2019;s
 patients are generally less than billed charges. The Company
 monitors its revenue and receivables from these sources and records
 an estimated contractual allowance to properly account for the
 anticipated differences between billed and reimbursed
 amounts.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Accordingly,
 patient service revenue is presented net of an estimated provision
 for contractual adjustments and uncollectibles. The Company
 estimates allowances for contractual adjustments and uncollectibles
 on accounts receivable based upon historical experience and other
 factors, including days sales outstanding (&#x201C;DSO&#x201D;) for
 accounts receivable, evaluation of expected adjustments and
 delinquency rates, past adjustments and collection experience in
 relation to amounts billed, an aging of accounts receivable,
 current contract and reimbursement terms, changes in payor mix and
 other relevant information. Contractual adjustments result from the
 difference between the physician rates for services performed and
 the reimbursements by government-sponsored healthcare programs and
 insurance companies for such services.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In addition,
 the Company generates revenue for services rendered under various
 coding and billing contracts. Contract terms are specific to each
 customer and may include a combination of a flat fee for coding of
 medical charts, a fixed fee per patient visit as well as a
 percentage of cash collections received by the providers. Revenue
 for flat and fixed fee arrangements is recognized in the month the
 coding occurs or the patient visit occurs. Revenue for percentage
 fees are recognized in the month that cash is collected for
 customers from payors. Revenue recorded for these services during
 2017 were immaterial.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Accounts
 receivable are primarily amounts due under <font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">fee-for-service</font></font> contracts from
 third-party payors, such as insurance companies, self-insured
 employers and patients and government-sponsored healthcare programs
 geographically dispersed throughout the United States and its
 territories. Concentration of credit risk relating to accounts
 receivable is limited by the number, diversity and geographic
 dispersion of the business units managed by the Company, as well as
 by the large number of patients and payors, including the various
 governmental agencies in the states in which the Company provides
 services. Receivables from government agencies made up
 approximately 17% of net accounts receivable at December&#xA0;31,
 2017 and 2016.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Cash and Cash
 Equivalents</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Cash
 equivalents are defined as all highly liquid financial instruments
 with maturities of 90 days or less from the date of purchase. The
 Company&#x2019;s cash equivalents typically consist of demand
 deposits, amounts on deposit in money market accounts, and funds
 invested in overnight repurchase agreements. Cash equivalent
 balances may, at certain times, exceed federally insured
 limits.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Certain cash
 equivalents carried by the Company are subject to the fair value
 provisions of the accounting guidance for fair value measurements.
 See &#x201C;Fair Value Measurements&#x201D; below.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Restricted
 Cash</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Restricted cash
 consists of funds in escrow related to a potential future payment
 for contingent consideration for an acquisition completed during
 the year ended December&#xA0;31, 2017. See Note 6 for more
 information regarding the underlying contingent consideration
 arrangement.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Investments</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Investments
 consist of municipal debt securities, federal home loan securities
 and certificates of deposit. Investments with remaining maturities
 of less than one year are classified as short-term investments.
 Investments classified as long-term have maturities of one year to
 six years.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 intends and has the ability to hold its securities to maturity, and
 therefore carries such investments at amortized cost in accordance
 with the provisions of the accounting guidance for investments in
 debt securities.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Property and
 Equipment</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Property and
 equipment are recorded at original purchase cost. Depreciation of
 property and equipment is computed using the straight-line method
 over the estimated useful lives of the underlying assets. Estimated
 useful lives are generally 30 years for buildings; three to seven
 years for medical equipment, computer equipment, software and
 furniture; and the lesser of the useful life or the remaining lease
 term for leasehold improvements and capital leases. Upon sale or
 retirement of property and equipment, the related cost and
 accumulated depreciation are eliminated from the respective
 accounts and any resulting gain or loss is included in
 earnings.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Business
 Acquisitions</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 accounts for all business acquisitions at fair value and expenses
 acquisition costs as they are incurred. Any identifiable assets
 acquired and liabilities assumed are recognized and measured at
 their respective fair values on the acquisition date. If
 information about facts and circumstances existing as of the
 acquisition date is incomplete at the end of the reporting period
 in which a business acquisition occurs, the Company will report
 provisional amounts for the items for which the accounting is
 incomplete. The measurement period ends once the Company receives
 sufficient information to finalize the fair values; however, the
 period will not exceed one year from the acquisition date. Prior to
 January&#xA0;1, 2016, any material adjustments recognized during
 the measurement period were required to be reflected
 retrospectively in the Consolidated Financial Statements of the
 subsequent period. Beginning on January&#xA0;1, 2016, any
 adjustments to provisional amounts that are identified during the
 measurement period are required to be recognized in the reporting
 period in which the adjustment amounts are determined.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In connection
 with certain acquisitions, the Company enters into agreements to
 pay additional amounts in cash or common stock based on the
 achievement of certain performance measures for up to five years
 ending after the acquisition dates. The Company measures this
 contingent consideration at fair value at the acquisition date and
 records such contingent consideration as a liability or equity on
 the Company&#x2019;s Consolidated Balance Sheets on the acquisition
 date. The fair value of each contingent consideration liability is
 remeasured at each reporting period with any change in fair value
 recognized as income or expense within operations in the
 Company&#x2019;s Consolidated Statements of Income. See Note 6 for
 more information on the Company&#x2019;s business
 acquisitions.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Goodwill and Other
 Intangible Assets</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 records acquired assets and assumed liabilities at their respective
 fair values under the acquisition method of accounting. Goodwill
 represents the excess of purchase price over the fair value of the
 net assets acquired. Intangible assets with finite lives,
 principally physician and hospital agreements, customer
 relationships, patented technology and trade names, are recognized
 apart from goodwill at the time of acquisition based on the
 contractual-legal and separability criteria established in the
 accounting guidance. Intangible assets with finite lives are
 amortized on either an accelerated basis based on the annual
 undiscounted economic cash flows associated with the particular
 intangible asset or on a straight-line basis over their estimated
 useful lives. Intangible assets with finite lives are amortized
 over periods of one to 20 years.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Goodwill is
 tested for impairment at a reporting unit level on at least an
 annual basis in accordance with the subsequent measurement
 provisions of the accounting guidance for goodwill. The Company
 defines a reporting unit based upon its management structure for
 services provided in specific regions of the United States. The
 Company early adopted new accounting guidance in 2017 that requires
 only a single-step quantitative test with any goodwill impairment
 measured as the amount by which a reporting unit&#x2019;s carrying
 value exceeds its fair value. The Company uses income and
 market-based valuation approaches to determine the fair value of
 its reporting units. These approaches focus on discounted cash
 flows and market multiples based on the Company&#x2019;s market
 capitalization to derive the fair value of a reporting unit. The
 Company also considers the economic outlook for the healthcare
 services industry and various other factors during the testing
 process, including hospital and physician contract changes, local
 market developments, changes in third-party payor payments, and
 other publicly available information. The Company completed annual
 impairment tests in the third quarter of each of 2017, 2016 and
 2015 and determined that goodwill was not impaired in any of the
 three years.</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 18px">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Long-Lived
 Assets</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company is
 required to evaluate long-lived assets, including intangible assets
 subject to amortization, whenever events or changes in
 circumstances indicate that the carrying value of the assets may
 not be fully recoverable. The recoverability of such assets is
 measured by a comparison of the carrying value of the assets to the
 future undiscounted cash flows before interest charges to be
 generated by the assets. If long-lived assets are impaired, the
 impairment to be recognized is measured as the excess of the
 carrying value over the fair value. Long-lived assets held for
 disposal are reported at the lower of the carrying value or fair
 value less disposal costs. The Company does not believe there are
 any indicators that would require an adjustment to such assets or
 their estimated periods of recovery at December&#xA0;31, 2017
 pursuant to current accounting standards.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Common Stock
 Repurchases</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 repurchases shares of its common stock as authorized from time to
 time by its Board of Directors. The Company treats repurchased
 shares of its common stock as retired as any repurchased shares
 become authorized but unissued shares. The reacquisition cost of
 repurchased shares is recorded as a reduction in the respective
 components of shareholders&#x2019; equity.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Professional Liability
 Coverage</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 maintains professional liability insurance policies with
 third-party insurers generally on a claims-made basis, subject to
 deductibles or self-insured retention, exclusions and other
 restrictions. The Company&#x2019;s self-insured retention under its
 professional liability insurance program is maintained primarily
 through a wholly owned captive insurance subsidiary. The Company
 records an estimate of liabilities for self-insured amounts and
 claims incurred but not reported based on an actuarial valuation
 using historical loss information, claim emergence patterns and
 various actuarial assumptions. Liabilities for claims incurred but
 not reported are not discounted.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Income
 Taxes</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 records deferred income taxes using the liability method, whereby
 deferred tax assets and liabilities are determined based on the
 difference between the financial statement and tax bases of assets
 and liabilities using enacted tax rates in effect for the year in
 which the differences are expected to reverse. If it is more likely
 than not that all or a portion of deferred tax assets will not be
 realized, a valuation allowance is provided against such deferred
 tax assets. In making such determination, the Company considers all
 available positive and negative evidence, including future
 reversals of existing taxable temporary differences, projected
 future taxable income, <font style="WHITE-SPACE: nowrap">tax-planning</font> strategies, and results
 of recent operations.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The accounting
 guidance for uncertain tax positions prescribes a recognition
 threshold and measurement attribute for financial statement
 recognition and measurement of a tax position taken or expected to
 be taken in a tax return. The guidance also requires policy
 disclosures regarding penalties and interest and extensive
 disclosures regarding increases and decreases in uncertain tax
 positions as a result of tax positions taken in a current or prior
 period, settlements with taxing authorities and any lapse of an
 applicable statute of limitations. Additional qualitative
 discussion is required for any tax position that may result in a
 significant increase or decrease in uncertain tax positions within
 a <font style="WHITE-SPACE: nowrap">12-month</font> period from the
 Company&#x2019;s reporting date.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Stock Incentive
 Plans</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 grants stock-based awards consisting primarily of restricted stock
 to key employees under its Amended and Restated 2008 Incentive
 Compensation Plan, as amended. The Company measures the cost of
 employee services received in exchange for stock-based awards based
 on grant-date fair value and allocates the resulting compensation
 expense over the corresponding requisite service period using the
 graded vesting attribution method. The Company also performs
 analyses to estimate forfeitures of stock-based awards on an annual
 basis and adjusts the estimates as necessary based on the number of
 awards that ultimately vest.</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 18px">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Net Income Per Common
 Share</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Basic net
 income per common share is calculated by dividing net income by the
 weighted average number of common shares outstanding during the
 period. Diluted net income per common share is calculated by
 dividing net income by the weighted average number of common and
 potential common shares outstanding during the period. Potential
 common shares consist of outstanding restricted stock, deferred
 stock and stock options and is calculated using the treasury stock
 method. On January&#xA0;1, 2017, the Company adopted new accounting
 guidance that no longer permits the Company to include the assumed
 excess tax benefits related to the potential exercise or vesting of
 its stock-based awards in the treasury stock method computation.
 The impact on the weighted average number of common and common
 equivalent shares outstanding from excluding such assumed excess
 tax benefits for the year ended December&#xA0;31, 2017 was not
 material. See &#x201C;Recently Adopted Accounting
 Pronouncements&#x201D; above for additional information on the
 adoption of the new accounting guidance.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Fair Value
 Measurements</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In accordance
 with the accounting guidance for fair value measurements and
 disclosures, the Company carries its money market funds included in
 cash and cash equivalents at fair value. In accordance with the
 three-tier fair value hierarchy under this guidance, the Company
 determined the fair value using quoted market prices, a
 Level&#xA0;1 input as defined under the accounting guidance for
 fair value measurements. At December&#xA0;31, 2017 and 2016, the
 Company&#x2019;s money market funds had a fair value of
 $9.2&#xA0;million and $12.4&#xA0;million, respectively.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 also carries the cash surrender value of life insurance related to
 its deferred compensation arrangements at fair value. The
 investments underlying the life insurance contracts consist
 primarily of exchange-traded equity securities and mutual funds
 with quoted prices in active markets. In accordance with the
 three-tier fair value hierarchy, the Company determined the fair
 value using the cash surrender value of the life insurance, a
 Level&#xA0;2 input as defined under the accounting guidance for
 fair value measurements. At December&#xA0;31, 2017 and 2016, the
 Company&#x2019;s cash surrender value of life insurance had a fair
 value of $15.6&#xA0;million and $15.8&#xA0;million,
 respectively.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In addition,
 the Company carries its contingent consideration liabilities
 related to acquisitions at fair value. In accordance with the
 three-tier fair value hierarchy, the Company determined the fair
 value of its contingent consideration liabilities using the income
 approach with assumed discount rates and payment probabilities. The
 income approach uses Level&#xA0;3, or unobservable inputs as
 defined under the accounting guidance for fair value measurements.
 At December&#xA0;31, 2017 and 2016, the Company&#x2019;s contingent
 consideration liabilities had a fair value of $30.5&#xA0;million
 and $17.3&#xA0;million, respectively. See Note 6 for more
 information regarding the Company&#x2019;s contingent consideration
 liabilities.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The carrying
 amounts of cash equivalents, short-term investments, accounts
 receivable and accounts payable and accrued expenses approximate
 fair value due to the short maturities of the respective
 instruments. The carrying values of long-term investments, line of
 credit, variable rate long-term debt and capital lease obligations
 approximate fair value. If the Company&#x2019;s investments were
 measured at fair value, they would be categorized as Level&#xA0;2
 in the fair value hierarchy. If the Company&#x2019;s line of credit
 and variable long-term debt were measured at fair value, they would
 be categorized as Level&#xA0;2 in the fair value hierarchy. See
 Note 10 for information regarding the fair value of the
 Company&#x2019;s 5.25% senior unsecured notes due 2023 (the
 &#x201C;2023 Notes&#x201D;).</font></p>
 </div><span></span>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6769225152">
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<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Investments<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
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<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
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<td class="text"><div>
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 <b>3.&#xA0;&#xA0;&#xA0;&#xA0;Investments:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 Investments held are summarized as follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31, 2017</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31, 2016</b></td>
 <td valign="bottom">&#xA0;</td>
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 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b><font style="WHITE-SPACE: nowrap">Short-Term</font></b></td>
 <td valign="bottom">&#xA0;</td>
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 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b><font style="WHITE-SPACE: nowrap">Long-Term</font></b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b><font style="WHITE-SPACE: nowrap">Short-Term</font></b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b><font style="WHITE-SPACE: nowrap">Long-Term</font></b></td>
 <td valign="bottom">&#xA0;</td>
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 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Municipal debt securities</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">8,312</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">46,195</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">10,306</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">46,513</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Federal home loan securities</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,000</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">30,322</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">28,747</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Certificates of deposit</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">980</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4,165</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">980</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">3,715</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">10,292</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">80,682</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">11,286</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">78,975</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 Contractual maturities of long-term investments are summarized as
 follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="74%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2017</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Due after one year through five years</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">78,561</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">70,005</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Due after five years through six years</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,121</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8,970</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">80,682</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">78,975</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for  investments in certain debt and equity securities.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -URI http://asc.fasb.org/topic&amp;trid=2196928<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 320<br> -URI http://asc.fasb.org/subtopic&amp;trid=4738149<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 940<br> -SubTopic 320<br> -URI http://asc.fasb.org/subtopic&amp;trid=2176304<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 946<br> -SubTopic 320<br> -URI http://asc.fasb.org/subtopic&amp;trid=2324412<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 320<br> -URI http://asc.fasb.org/subtopic&amp;trid=2209399<br><br>Reference 6: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 954<br> -SubTopic 320<br> -URI http://asc.fasb.org/subtopic&amp;trid=2289146<br></p></div>
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<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accounts Receivable and Net Revenue<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
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 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt">
 <b>4.&#xA0;&#xA0;&#xA0;&#xA0;Accounts Receivable and Net
 Revenue:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 Accounts receivable, net consists of the following (in
 thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="65%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2017</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
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 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Gross accounts receivable</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,790,034</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,719,642</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
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 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Allowance for contractual adjustments and uncollectibles</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(1,286,035</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">503,999</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">495,276</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 Net revenue consists of the following (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="59%"></td>
 <td valign="bottom" width="3%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="3%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="3%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="10" align="center"><b>Years Ended
 December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2017</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2015</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Gross revenue</p>
 </td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">11,427,238</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">10,374,813</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">8,942,957</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Contractual adjustments and uncollectibles</p>
 </td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(8,285,317</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(7,464,030</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(6,389,195</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Hospital contract administrative fees</p>
 </td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">316,391</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">272,376</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">226,234</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">3,458,312</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">3,183,159</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">2,779,996</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 Accounts receivable of $504.0&#xA0;million and $495.3&#xA0;million
 at December&#xA0;31, 2017 and 2016, respectively, consist primarily
 of amounts due from government-sponsored healthcare programs and
 third-party insurance payors for services provided by the
 Company&#x2019;s affiliated physicians.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 Net revenue of $3.5&#xA0;billion, $3.2&#xA0;billion and
 $2.8&#xA0;billion for the years ended December&#xA0;31, 2017, 2016
 and 2015, respectively, consists primarily of gross billed charges
 for services provided by the Company&#x2019;s affiliated physicians
 less an estimated allowance for contractual adjustments and
 uncollectibles to properly account for the anticipated differences
 between gross billed charge amounts and expected reimbursement
 amounts.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 The Company&#x2019;s contractual adjustments and uncollectibles as a
 percentage of gross patient service revenue vary slightly each year
 depending on several factors, including improved managed care
 contracting, changes in reimbursement from state Medicaid programs
 and other government-sponsored programs, shifts in the percentage
 of patient services being reimbursed under government-sponsored
 programs and annual price increases.</p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The
 Company&#x2019;s annual price increases typically increase
 contractual adjustments as a percentage of gross patient service
 revenue. This increase is primarily due to Medicaid, Medicare and
 other government-sponsored healthcare programs that generally
 provide for reimbursements on a <font style="WHITE-SPACE: nowrap">fee-schedule</font> basis rather than on a
 gross charge basis. When the Company bills these programs, like
 other payors, on a gross-charge basis, it also increases its
 provision for contractual adjustments and uncollectibles by the
 amount of any price increase, resulting in a higher contractual
 adjustment percentage.</font></p>
 </div><span></span>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for claims held for amounts due a entity, excluding financing receivables. Examples include, but are not limited to, trade accounts receivables, notes receivables, loans receivables. Includes disclosure for allowance for credit losses.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 310<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84173941&amp;loc=d3e5066-111524<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(4))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 946<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.6-04(6))<br> -URI http://asc.fasb.org/extlink&amp;oid=6488278&amp;loc=d3e603758-122996<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(3))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 310<br> -SubTopic 10<br> -Section 50<br> -Paragraph 11<br> -URI http://asc.fasb.org/extlink&amp;oid=84173941&amp;loc=d3e5162-111524<br><br>Reference 6: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-03(a)(5))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879938&amp;loc=d3e572229-122910<br><br>Reference 7: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-03(7))<br> -URI http://asc.fasb.org/extlink&amp;oid=6876686&amp;loc=d3e534808-122878<br><br>Reference 8: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 310<br> -SubTopic 10<br> -Section 50<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=84173941&amp;loc=d3e5074-111524<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6769211088">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Property and Equipment<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
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 <p style="margin-top:18px;margin-bottom:0px"><font style="font-family:Times New Roman" size="2"><b>5.&#xA0;&#xA0;&#xA0;&#xA0;Property and
 Equipment:</b></font></p>
 <p style="margin-top:6px;margin-bottom:0px; text-indent:4%">
 <font style="font-family:Times New Roman" size="2">Property and
 equipment consists of the following (in thousands):</font></p>
 <p style="font-size:12px;margin-top:0px;margin-bottom:0px">
 &#xA0;</p>
 <table cellspacing="0" cellpadding="0" width="76%" border="0" style="BORDER-COLLAPSE:COLLAPSE" align="center">
 <tr>
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 <td valign="bottom" width="7%"></td>
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 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
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 <tr style="page-break-inside:avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" colspan="6" align="center" style="border-bottom:1px solid #000000"><font style="font-family:Times New Roman" size="1"><b>December&#xA0;31,</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="page-break-inside:avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"><font style="font-family:Times New Roman" size="1"><b>2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"><font style="font-family:Times New Roman" size="1"><b>2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr bgcolor="#CCEEFF" style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">Building</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">33,024</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">26,572</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">Land</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">6,683</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">6,683</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr bgcolor="#CCEEFF" style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">Equipment and
 other</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">253,453</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">213,521</font></td>
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 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
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 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
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 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
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 <tr style="page-break-inside:avoid">
 <td valign="top"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">293,160</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
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 <tr bgcolor="#CCEEFF" style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">Accumulated
 depreciation</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">(169,624</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">(143,708</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="font-size:1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="page-break-inside:avoid">
 <td valign="top"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">123,536</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">103,068</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="font-size:1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="margin-top:12px;margin-bottom:0px; text-indent:4%">
 <font style="font-family:Times New Roman" size="2">At
 December&#xA0;31, 2017 and 2016, property and equipment includes
 medical and other equipment held under capital leases of
 $6.1&#xA0;million and $6.2&#xA0;million, and related accumulated
 depreciation of $4.6&#xA0;million and $4.0&#xA0;million,
 respectively. The Company recorded depreciation expense of
 $33.9&#xA0;million, $29.0&#xA0;million and $22.2&#xA0;million for
 the years ended December&#xA0;31, 2017, 2016 and 2015,
 respectively.</font></p>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for long-lived, physical assets used in the normal conduct of business and not intended for resale. Includes, but is not limited to, accounting policies and methodology, roll forwards, depreciation, depletion and amortization expense, including composite depreciation, accumulated depreciation, depletion and amortization expense, useful lives and method used, income statement disclosures, assets held for sale and public utility disclosures.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -URI http://asc.fasb.org/topic&amp;trid=2155823<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6930817728">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Business Acquisitions<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationsAbstract', window );"><strong>Business Combinations [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
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<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationDisclosureTextBlock', window );">Business Acquisitions</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>6.&#xA0;&#xA0;&#xA0;&#xA0;Business
 Acquisitions:</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">During the year
 ended December&#xA0;31, 2017, the Company completed 10 physician
 group practice acquisitions, including four radiology practices,
 two maternal-fetal medicine practices, one neonatology practice,
 one pediatric multi-specialty practice and two other pediatric
 subspecialty practices. The acquisition-date fair value of the
 total consideration for the 10 acquisitions was
 $554.0&#xA0;million, net of cash acquired. Approximately
 $531.7&#xA0;million was paid in cash, $2.7&#xA0;million was paid by
 issuing 69,014 shares of the Company&#x2019;s common stock,
 $18.6&#xA0;million was recorded as a contingent consideration
 liability and $1.0&#xA0;million was recorded as accrued purchase
 consideration within other current liabilities.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">These
 acquisitions expanded the Company&#x2019;s national network of
 physician practices. The Company expects to improve the results of
 physician practices through improved managed care contracting,
 improved collections and identification of growth initiatives, as
 well as operating and cost savings based on the significant
 infrastructure it has developed. With respect to the
 Company&#x2019;s acquisition of radiology physician practices, the
 Company believes that it brings a unique value proposition to
 radiology physician groups, in that the Company can provide not
 only practice support, but also teleradiology capabilities that can
 enhance a physician group&#x2019;s efficiency, provide subspecialty
 access and help them grow, remain competitive and meet the ever
 increasing demands of their hospital partners, payors and
 regulatory bodies. In addition, the Company believes that radiology
 physician group practice physicians can complement the staffing
 needs for its teleradiology services business during certain times,
 such as nights and weekends, when such physicians are not providing
 services at their practices.</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The 69,014
 shares of the Company&#x2019;s common stock issued as a component of
 the purchase consideration for acquisitions completed during the
 first quarter and fourth quarter of 2017 had an acquisition-date
 fair value of $2.7&#xA0;million. The fair value of such shares was
 determined using the closing price on the New York Stock Exchange
 of the Company&#x2019;s common stock less a discount for lack of
 marketability on the respective dates of acquisition, reflecting a
 three year contractual restriction on the disposition or assignment
 of such common stock.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The
 Company&#x2019;s preliminary allocation of purchase price is as
 follows (in thousands):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="68%" align="center" border="0">
 <tr>
 <td width="83%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Current assets</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">43,550</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Property and
 equipment</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">5,281</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Other noncurrent
 assets</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">52,611</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Goodwill</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">439,822</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Other intangible
 assets</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">39,414</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Current
 liabilities</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(5,674</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Other long-term
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 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(21,086</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">553,918</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company has
 recorded provisional amounts for deferred income taxes related to
 certain acquisitions completed during the year ended
 December&#xA0;31, 2017. Any adjustments will be recorded during the
 measurement period and are not expected to be material.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Current assets
 acquired and other noncurrent assets acquired include assets with a
 fair value of $23.5&#xA0;million and $22.5&#xA0;million,
 respectively, that are expected to be sold and contributed to a
 joint venture for an equity method investment in that joint
 venture, respectively, within the next twelve months. Accordingly,
 these assets are classified as held for sale.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The contingent
 consideration of $18.6&#xA0;million recorded during the year ended
 December&#xA0;31, 2017 is related to an agreement to pay an
 additional cash amount based on the achievement of certain
 performance measures for the period through June&#xA0;1, 2019. The
 accrued contingent consideration was recorded as a liability at
 acquisition-date fair value using the income approach with assumed
 discount rates ranging from 4.0% to 4.75% over the applicable terms
 and an assumed payment probability assessment over the applicable
 years. The range of the undiscounted amount the Company could pay
 under the contingent consideration agreement is between $0 and
 $20.0&#xA0;million. In connection with this contingent
 consideration arrangement, the Company has designated
 $20.0&#xA0;million as restricted cash in its Consolidated Balance
 Sheet. In addition, during the year ended December&#xA0;31, 2017,
 the Company paid $6.2&#xA0;million for contingent consideration
 related to certain prior-period acquisitions, of which all but the
 accretion recorded during 2017 was accrued as of December&#xA0;31,
 2016.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In connection
 with certain prior period acquisitions, the Company recorded an
 increase in deferred tax liabilities of $0.5&#xA0;million with a
 corresponding increase in goodwill of $0.5&#xA0;million resulting
 from the finalization of income tax acquisition
 accounting.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">During the year
 ended December&#xA0;31, 2016, the Company completed 15
 acquisitions, of which 13 were physician group practices including
 eight anesthesiology practices, two other pediatric subspecialty
 practices, one neonatology practice, one maternal-fetal medicine
 practice and one pediatric cardiology practice. In addition, the
 Company acquired a third-party receivables company and a patient
 engagement software company as additions to its existing management
 services organization. The total consideration for the 15
 acquisitions was $759.6&#xA0;million, net of $15.0&#xA0;million
 cash acquired, of which $756.1&#xA0;million was paid in cash and
 $3.5&#xA0;million was recorded as a contingent consideration
 liability.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">On
 March&#xA0;31, 2017, the Company sold its 75% economic interest in
 a joint venture that was previously consolidated. The
 deconsolidation and removal of 100% of the carrying value of the
 joint venture&#x2019;s net assets resulted in a gain on sale that
 was not material.</font></p>
 </div><span></span>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for a business combination (or series of individually immaterial business combinations) completed during the period, including background, timing, and recognized assets and liabilities. The disclosure may include leverage buyout transactions (as applicable).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -URI http://asc.fasb.org/topic&amp;trid=2303972<br></p></div>
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<tr>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6769193904">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Goodwill and Intangible Assets<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract', window );"><strong>Goodwill and Intangible Assets Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock', window );">Goodwill and Intangible Assets</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>7.&#xA0;&#xA0;&#xA0;&#xA0;Goodwill and Intangible
 Assets:</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Goodwill was
 $4.3&#xA0;billion and $3.8&#xA0;billion at December&#xA0;31, 2017
 and 2016, respectively. The change in the carrying amount of
 goodwill of $438.8&#xA0;million during the year ended
 December&#xA0;31, 2017 is primarily related to the Company&#x2019;s
 2017 acquisitions. The Company expects that $159.5&#xA0;million of
 the goodwill recorded during the year ended December&#xA0;31, 2017
 will be deductible for tax purposes.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Intangible
 assets, net, consist of the following (in thousands):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="64%"></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>December&#xA0;31,
 2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Gross<br />
 Carrying<br />
 Value</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Accumulated<br />
 Amortization</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Net<br />
 Carrying<br />
 Value</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Physician and hospital
 agreements</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">381,635</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(203,915</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">177,720</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Customer
 relationships</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">443,300</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(48,837</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">394,463</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Trade names</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">43,156</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(2,933</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">40,223</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Patented and other
 technology</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">38,590</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(11,068</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">27,522</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">906,681</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(266,753</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">639,928</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="64%"></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>December&#xA0;31,
 2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Gross<br />
 Carrying<br />
 Value</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Accumulated<br />
 Amortization</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Net<br />
 Carrying<br />
 Value</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Physician and hospital
 agreements</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">347,862</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(168,488</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">179,374</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Customer
 relationships</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">443,300</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(27,368</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">415,932</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Trade names</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">43,156</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(1,604</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">41,552</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Patented and other
 technology</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">37,503</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(5,832</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">31,671</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">871,821</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(203,292</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">668,529</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">During the year
 ended December&#xA0;31, 2017, the Company recorded intangible
 assets related to acquisitions totaling $39.4&#xA0;million,
 consisting primarily of physician and hospital agreements. The
 weighted-average amortization period for these physician and
 hospital agreements is approximately 10 years.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Amortization
 expense for intangible assets was $68.9&#xA0;million,
 $60.3&#xA0;million and $42.0&#xA0;million for the years ended
 December&#xA0;31, 2017, 2016 and 2015, respectively.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Amortization
 expense for existing intangible assets for the next five years is
 expected to be as follows (in thousands):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="68%" align="center" border="0">
 <tr>
 <td width="84%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2018</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">67,514</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2019</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">62,669</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2020</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">56,636</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2021</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">51,069</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2022</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">44,357</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 </table>
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</tr>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for the aggregate amount of goodwill and a description of intangible assets, which may include (a) for amortizable intangible assets (also referred to as finite-lived intangible assets), the carrying amount, the amount of any significant residual value, and the weighted-average amortization period, (b) for intangible assets not subject to amortization (also referred to as indefinite-lived intangible assets), the carrying amount, and (c) the amount of research and development assets acquired and written off in the period, including the line item in the income statement in which the amounts written off are aggregated, if not readily apparent from the income statement. Also discloses (a) for amortizable intangibles assets in total and by major class, the gross carrying amount and accumulated amortization, the total amortization expense for the period, and the estimated aggregate amortization expense for each of the five succeeding fiscal years, (b) for intangible assets not subject to amortization the carrying amount in total and by major class, and (c) for goodwill, in total and for each reportable segment, the changes in the carrying amount of goodwill during the period (including the aggregate amount of goodwill acquired, the aggregate amount of impairment losses recognized, and the amount of goodwill included in the gain (loss) on disposal of a reporting unit). If any part of goodwill has not been allocated to a reportable segment, discloses the unallocated amount and the reasons for not allocating. For each impairment loss recognized related to an intangible asset (excluding goodwill), discloses: (a) a description of the impaired intangible asset and the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method for determining fair value, (c) the caption in the income statement or the statement of activities in which the impairment loss is aggregated, and (d) the segment in which the impaired intangible asset is reported. For each goodwill impairment loss recognized, discloses: (a) a description of the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method of determining the fair value of the associated reporting unit, and (c) if a recognized impairment loss is an estimate not finalized and the reasons why the estimate is not final.  May also disclose the nature and amount of any significant adjustments made to a previous estimate of an impairment loss.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -URI http://asc.fasb.org/topic&amp;trid=2144416<br></p></div>
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<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accounts Payable and Accrued Expenses<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
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 <p style="margin-top:0px;margin-bottom:0px"><font style="font-family:Times New Roman" size="2"><b>8.&#xA0;&#xA0;&#xA0;&#xA0;Accounts Payable and Accrued
 Expenses:</b></font></p>
 <p style="margin-top:6px;margin-bottom:0px; text-indent:4%">
 <font style="font-family:Times New Roman" size="2">Accounts payable
 and accrued expenses consist of the following (in
 thousands):</font></p>
 <p style="font-size:12px;margin-top:0px;margin-bottom:0px">
 &#xA0;</p>
 <table cellspacing="0" cellpadding="0" width="76%" border="0" style="BORDER-COLLAPSE:COLLAPSE" align="center">
 <tr>
 <td width="70%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
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 <td></td>
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 <tr style="page-break-inside:avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
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 <td valign="bottom"><font size="1">&#xA0;</font></td>
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 <tr style="page-break-inside:avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"><font style="font-family:Times New Roman" size="1"><b>2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"><font style="font-family:Times New Roman" size="1"><b>2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr bgcolor="#CCEEFF" style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">Accounts payable</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">34,632</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">28,474</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">Accrued salaries and
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 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">225,429</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">220,635</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr bgcolor="#CCEEFF" style="page-break-inside:avoid">
 <td valign="top">
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 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">75,672</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">67,830</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">Accrued professional
 liabilities</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">37,912</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">28,972</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr bgcolor="#CCEEFF" style="page-break-inside:avoid">
 <td valign="top">
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 consideration</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">6,259</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">6,566</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="page-break-inside:avoid">
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 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">4,495</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">4,511</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr bgcolor="#CCEEFF" style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">Other accrued
 expenses</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">53,618</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">50,950</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="font-size:1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="page-break-inside:avoid">
 <td valign="top"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">438,017</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">407,938</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
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 <td valign="bottom"></td>
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 <p style="border-top:3px double #000000">&#xA0;</p>
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 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
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 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for accounts payable and accrued liabilities at the end of the reporting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.19(a),20,24)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6637408304">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accrued Professional Liabilities<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HealthCareOrganizationsAbstract', window );"><strong>Health Care Organizations [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyDisclosureTextBlock', window );">Accrued Professional Liabilities</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>9.&#xA0;&#xA0;&#xA0;&#xA0;Accrued Professional
 Liabilities:</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">At
 December&#xA0;31, 2017 and 2016, the Company&#x2019;s total accrued
 professional liabilities of $250.2&#xA0;million and
 $202.1&#xA0;million, respectively, includes incurred but not
 reported loss reserves of $138.5&#xA0;million and
 $128.1&#xA0;million, respectively, and loss reserves for reported
 claims of $111.7&#xA0;million and $74.0&#xA0;million, respectively.
 Of the total liability, $37.9&#xA0;million is classified as a
 current liability within accounts payable and accrued expenses in
 the Consolidated Balance Sheet. In addition, there is a
 corresponding insurance receivable of $18.9&#xA0;million recorded
 as a component of other assets for certain professional liability
 claims that are covered by third-party insurance
 policies.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The activity
 related to the Company&#x2019;s total accrued professional liability
 for the years ended December&#xA0;31, 2017, 2016 and 2015 is as
 follows (in thousands):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="63%"></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Years Ended
 December&#xA0;31,</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2015</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Balance at beginning of
 year</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">202,052</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">202,527</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">168,369</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Assumed liabilities through
 acquisition</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">20,716</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">&#x2014;&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">35,968</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Provision (adjustment) for
 losses related to:</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Current year</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">41,291</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">38,129</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">39,204</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Prior years</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">9,983</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(25,428</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(25,797</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Total provision for
 losses</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">51,274</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">12,701</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">13,407</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Claim payments related
 to:</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Current year</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(712</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(766</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(1,382</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Prior years</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(23,143</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(12,410</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(13,835</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Total payments</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(23,855</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(13,176</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(15,217</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Balance at end of
 year</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">250,187</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">202,052</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">202,527</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The net
 increase in the Company&#x2019;s total accrued professional
 liability for the year ended December&#xA0;31, 2017 is primarily
 related to growth in the program from acquisitions as well as
 overall unfavorable trends in the Company&#x2019;s claims
 experience. The net decrease in 2016 was primarily attributable to
 the overall favorable trends in the Company&#x2019;s claims
 experience.</font></p>
 </div><span></span>
</td>
</tr>
</table>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for the accrual for malpractice loss contingencies (general and professional liability) which may include the policy used for accruing the loss contingency, the nature and amount of any accrual, and any significant estimate used to determine the accrual.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 954<br> -SubTopic 450<br> -URI http://asc.fasb.org/subtopic&amp;trid=2289286<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 450<br> -URI http://asc.fasb.org/topic&amp;trid=2127136<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6769236320">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Line of Credit, Long-Term Debt and Capital Lease Obligations<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtDisclosureAbstract', window );"><strong>Debt Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock', window );">Line of Credit, Long-Term Debt and Capital Lease Obligations</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>10.&#xA0;&#xA0;&#xA0;&#xA0;Line of Credit, Long-Term Debt
 and Capital Lease Obligations:</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">On
 October&#xA0;30, 2017, the Company entered into a new credit
 agreement (the &#x201C;New Credit Agreement&#x201D;), which replaces
 the Company&#x2019;s prior credit agreement. The New Credit
 Agreement provides for a $2.0&#xA0;billion unsecured revolving
 credit facility and includes a $37.5&#xA0;million <font style="WHITE-SPACE: nowrap">sub-facility</font> for the issuance of
 letters of credit. The New Credit Agreement matures on
 October&#xA0;31, 2022 and is guaranteed by substantially all of the
 Company&#x2019;s subsidiaries and affiliated professional
 associations and corporations. At the Company&#x2019;s option,
 borrowings under the New Credit Agreement will bear interest at
 (i)&#xA0;the alternate base rate (defined as the higher of
 (a)&#xA0;the prime rate, (b)&#xA0;the Federal Funds Rate plus 1/2
 of 1.00% and (c)&#xA0;LIBOR for an interest period of one month
 plus 1.00%) plus an applicable margin rate ranging from 0.125% to
 0.750% based on the Company&#x2019;s consolidated leverage ratio or
 (ii)&#xA0;the LIBOR rate plus an applicable margin rate ranging
 from 1.125% to 1.750% based on the Company&#x2019;s consolidated
 leverage ratio. The New Credit Agreement also calls for other
 customary fees and charges, including an unused commitment fee
 ranging from 0.150% to 0.300% of the unused lending commitments,
 based on the Company&#x2019;s consolidated leverage
 ratio.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The New Credit
 Agreement contains customary covenants and restrictions, including
 covenants that require the Company to maintain a minimum interest
 charge ratio, not to exceed a specified consolidated leverage ratio
 and to comply with laws, and restrictions on the ability of the
 Company to pay dividends and make certain other distributions, as
 specified therein. Failure to comply with these covenants would
 constitute an event of default under the New Credit Agreement,
 notwithstanding the ability of the Company to meet its debt service
 obligations. The New Credit Agreement also includes various
 customary remedies for the lenders following an event of default,
 including the acceleration of repayment of outstanding amounts
 under the New Credit Agreement.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">On
 December&#xA0;8, 2015, the Company completed a private offering of
 $750.0&#xA0;million aggregate principal amount of 2023 Senior
 Notes. The Company&#x2019;s obligations under the 2023 Senior Notes
 are guaranteed on an unsecured senior basis by the same
 subsidiaries and affiliated professional contractors that guarantee
 the Credit Agreement. Interest on the 2023 Senior Notes accrues at
 the rate of 5.25% per annum and is payable semi-annually in arrears
 on June&#xA0;1 and December 1.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">At any time
 prior to December&#xA0;1, 2018, the Company may redeem all or a
 portion of the 2023 Senior Notes at a redemption price equal to
 100% of the principal amount of the notes being redeemed plus an
 applicable redemption premium and accrued and unpaid interest to
 the redemption date. In addition, at any time prior to
 December&#xA0;1, 2018, the Company may redeem up to 35% of the
 aggregate principal amount of the 2023 Senior Notes at a redemption
 price of 105.250% of the principal amount thereof, plus accrued and
 unpaid interest, if any, to the redemption date, using proceeds
 from one or more equity offerings. On or after December&#xA0;1,
 2018, the Company may redeem all or a portion of the 2023 Senior
 Notes, at the redemption prices of 103.938% in 2018, 102.625% in
 2019, 101.313% in 2020 and 100% in 2021 and thereafter, plus
 accrued and unpaid interest to the redemption date.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The indenture
 under which the 2023 Senior Notes are issued, among other things,
 limits our ability to (1)&#xA0;incur liens and (2)&#xA0;enter into
 sale and lease-back transactions, and also limits our ability to
 merge or dispose of all or substantially all of our assets, in all
 cases, subject to a number of customary exceptions. Although we are
 not required to make mandatory redemption or sinking fund payments
 with respect to the 2023 Senior Notes, upon the occurrence of a
 change in control of MEDNAX, we may be required to repurchase the
 2023 Senior Notes at a purchase price equal to 101% of the
 aggregate principal amount of the 2023 Senior Notes repurchased
 plus accrued and unpaid interest.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 presents issuance costs related to long-term debt liabilities,
 other than revolving credit arrangements, as a direct deduction
 from the carrying value of that long-term debt.</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The carrying
 value of the Company&#x2019;s long-term debt was $1.8&#xA0;billion
 and $1.7&#xA0;billion at December&#xA0;31, 2017 and 2016,
 respectively, and consisted of the following (in
 thousands):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="56%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>December&#xA0;31,
 2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Principal</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Unamortized<br />
 Debt<br />
 Issuance<br />
 Costs</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Total</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2023 Senior
 Notes</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">750,000</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(9,503</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">740,497</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Revolving line of
 credit</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,110,500</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(4,864</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,105,636</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Total</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,860,500</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(14,367</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,846,133</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="57%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>December&#xA0;31,
 2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Principal</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Unamortized<br />
 Debt<br />
 Issuance<br />
 Costs</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Total</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2023 Senior
 Notes</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">750,000</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(11,109</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">738,891</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Revolving line of
 credit</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">783,500</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(3,388</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">780,112</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Term loan</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">180,000</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(259</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">179,741</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,713,500</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(14,756</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,698,744</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Less: Current
 portion</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(20,000</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">&#x2014;&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(20,000</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Long-term
 portion</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,693,500</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(14,756</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,678,744</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company has
 outstanding letters of credit which reduced the amount available
 under the New Credit Agreement by $0.2&#xA0;million at
 December&#xA0;31, 2017. At December&#xA0;31, 2017, the Company had
 an available balance on its New Credit Agreement of
 $889.3&#xA0;million.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The carrying
 values of the Company&#x2019;s variable rate revolving line of
 credit approximates fair value due to the short-term nature of the
 interest rates. The estimated fair value of the Company&#x2019;s
 2023 Notes was $763.1&#xA0;million and $773.4&#xA0;million, at
 December&#xA0;31, 2017 and 2016, respectively, and was estimated
 using trading prices as of December&#xA0;31, 2017 and
 December&#xA0;31, 2016 as Level&#xA0;2 inputs to estimate fair
 value.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The
 Company&#x2019;s capital lease obligations consist of the following
 (in thousands):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="75%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="6" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>December&#xA0;31,</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Capital lease
 obligations</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,826</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">3,550</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Less: Current
 portion</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(1,401</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(2,054</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Long-term
 portion</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">425</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,496</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The amounts due
 under the terms of the Company&#x2019;s capital lease obligations at
 December&#xA0;31, 2017 are as follows:</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="68%" align="center" border="0">
 <tr>
 <td width="86%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2018</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,401</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2019</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">238</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2020</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">113</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2021</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">74</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 </table>
 </div><span></span>
</td>
</tr>
</table>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for debt and capital lease obligations can be reported. Information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants. Also includes descriptions and amounts of capital leasing arrangements that consist of direct financing, sales type and leveraged leases. Disclosure may include the effect on the balance sheet and the income statement resulting from a change in lease classification for leases that at inception would have been classified differently had guidance been in effect at the inception of the original lease.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -URI http://asc.fasb.org/topic&amp;trid=2208923<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 470<br> -URI http://asc.fasb.org/topic&amp;trid=2208564<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6769193232">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Income Taxes<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxDisclosureAbstract', window );"><strong>Income Tax Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
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</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxDisclosureTextBlock', window );">Income Taxes</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 0pt">
 <b>11.&#xA0;&#xA0;&#xA0;&#xA0;Income Taxes:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 The components of the income tax provision (benefit) are as follows
 (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="62%"></td>
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 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2017</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2015</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Federal:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Current</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">130,053</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">166,758</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">168,596</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
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 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Deferred</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(63,038</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">15,596</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">12,866</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
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 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">67,015</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">182,354</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">181,462</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 State:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Current</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">20,070</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4,296</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">20,948</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Deferred</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,965</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,553</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,628</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">23,035</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6,849</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">22,576</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">90,050</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">189,203</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">204,038</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 The Company files its tax return on a consolidated basis with its
 subsidiaries. The remaining affiliated professional contractors
 file tax returns on an individual basis.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 The effective tax rate was 21.94%, 36.80% and 37.76% for the years
 ended December&#xA0;31, 2017, 2016 and 2015, respectively. During
 the three months ended December&#xA0;31, 2017, the Company recorded
 a $70.0&#xA0;million income tax benefit related to the reduction of
 its net deferred tax liability resulting from the reduction in the
 corporate tax rate enacted in December 2017 under the Tax Cuts and
 Jobs Act of 2017. Excluding this favorable impact, our effective
 income tax rate for the year ended December&#xA0;31, 2017 was
 39.00%. During the three months ended September&#xA0;30, 2016, the
 Company settled a certain tax matter with a taxing authority. In
 connection with this settlement, the Company&#x2019;s effective
 income tax rate was favorably impacted by $10.6&#xA0;million.
 Excluding this favorable impact, the effective tax rate for
 December&#xA0;31, 2016 was 38.87%, as compared to 37.76% for
 2015.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 The differences between the effective rate and the United States
 federal income tax statutory rate are as follows:</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="75%"></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2017</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2015</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Tax at statutory rate</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">35.00</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">35.00</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">35.00</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 State income tax, net of federal benefit</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">3.33</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2.94</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2.97</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 <font style="WHITE-SPACE: nowrap">Non-deductible</font>
 expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.49</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.43</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.34</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Change in accrual estimates relating to uncertain tax positions</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.02</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(2.11</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(0.43</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Change in valuation allowance</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.48</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.29</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Other, net</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.16</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.06</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(0.41</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Change in tax law</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17.06</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income tax provision</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">21.94</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">36.80</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">37.76</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">All of the
 Company&#x2019;s deferred tax assets and liabilities are classified
 as long-term. The significant components of deferred income tax
 assets and liabilities are as follows (in thousands):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="69%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="6" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>December&#xA0;31,</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Allowance for uncollectible
 accounts</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">80,056</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">103,525</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Reserves and
 accruals</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">45,454</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">62,212</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Stock-based
 compensation</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">7,975</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">13,726</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Net operating loss
 carryforward</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">28,569</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">49,156</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Property and
 equipment</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">685</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,621</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Other</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">970</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,610</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Deferred tax assets before
 valuation allowance</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">163,709</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">231,850</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Less: Valuation
 allowance</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(2,615</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(4,014</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Deferred tax assets, net of
 valuation allowance</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">161,094</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">227,836</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Gross deferred tax
 liabilities:</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Amortization</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(258,618</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(380,594</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Accrual to cash
 adjustment</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(31,290</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(53,771</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Other</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(4,150</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(1,023</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 5em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Total deferred tax
 liabilities</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(294,058</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(435,388</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 5em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Net deferred tax
 liability</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(132,964</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(207,552</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The
 Company&#x2019;s net deferred tax liability decreased by
 $74.6&#xA0;million during 2017 of which $70.0&#xA0;million is
 related to a reduction in the corporate tax rate enacted under the
 Tax Cuts and Jobs Act of 2017.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Beginning
 January&#xA0;1, 2017, excess tax benefits or deficiencies
 associated with the exercise of stock options, the vesting of
 restricted and deferred stock and the purchase of shares under the
 Company&#x2019;s <font style="WHITE-SPACE: nowrap">non-qualified</font> employee stock purchase
 plan are recognized as income tax benefits or expenses in the
 income statement in the reporting period in which they occur
 instead of an increase or decrease to additional <font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">paid-in-capital.</font></font> For the year
 ended December&#xA0;31, 2017, income tax expense of
 $0.2&#xA0;million was recognized for excess tax deficiencies. For
 the years ended December&#xA0;31, 2016 and 2015, respectively,
 additional <font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">paid-in-capital</font></font> was increased
 by $4.2&#xA0;million and $11.6&#xA0;million for excess tax
 benefits.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company has
 net operating loss carryforwards for federal and state tax purposes
 totaling $116.0&#xA0;million, $130.0&#xA0;million, and
 $136.6&#xA0;million at December&#xA0;31, 2017, 2016 and 2015,
 respectively, expiring at various times in 2019 through
 2037.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">As of
 December&#xA0;31, 2017, 2016 and 2015, the Company&#x2019;s
 liability for uncertain tax positions, excluding accrued interest
 and penalties, was $11.0&#xA0;million, $9.5&#xA0;million and
 $18.4&#xA0;million, respectively. As of December&#xA0;31, 2017, the
 Company had $10.7&#xA0;million of uncertain tax positions that, if
 recognized, would favorably impact its effective tax
 rate.</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The following
 table summarizes the activity related to the Company&#x2019;s
 liability for uncertain tax positions for the years ended
 December&#xA0;31, 2017, 2016 and 2015 (in thousands):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="66%"></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Years Ended
 December&#xA0;31,</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2015</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Balance at beginning of
 year</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">9,469</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">18,447</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">17,165</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Increases related to prior
 year tax positions</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">2,284</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">301</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">467</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Decreases related to prior
 year tax positions</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(143</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(3,927</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(1,168</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Increases related to
 current year tax positions</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,430</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">2,258</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">3,675</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Settlements</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">&#x2014;&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(5,644</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">&#x2014;&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Decreases related to lapse
 of statutes of limitation</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(2,068</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(1,966</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(1,692</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Balance at end of
 year</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">10,972</font></td>
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 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">9,469</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">18,447</font></td>
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 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
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 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
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 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
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 <td valign="bottom">&#xA0;&#xA0;</td>
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 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
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 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
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 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">During the year
 ended December&#xA0;31, 2017, the Company increased its liability
 for uncertain tax positions by a total of $1.5&#xA0;million,
 primarily related to additional taxes on current and prior year
 positions, partially offset by the expiration of statutes of
 limitation. During the year ended December&#xA0;31, 2016, the
 Company decreased its liability for uncertain tax positions by a
 total of $9.0&#xA0;million, primarily related to the settlement of
 a certain tax matter with a taxing authority and the expiration of
 statutes of limitation, partially offset by additional taxes on
 current year positions.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In addition,
 the Company anticipates that its liability for uncertain tax
 positions will be decreased by $1.1&#xA0;million related to the
 expiration of certain statutes of limitation over the next 12
 months.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 includes interest and penalties related to income tax liabilities
 in income tax expense. The Company recognized an income tax benefit
 of $0.2&#xA0;million and $7.9&#xA0;million and income tax expense
 of $0.6&#xA0;million related to interest and penalties during the
 years ended December&#xA0;31, 2017, 2016 and 2015, respectively. At
 December&#xA0;31, 2017 and 2016, the Company&#x2019;s accrued
 liability for interest and penalties related to income tax
 liabilities totaled $1.2&#xA0;million and $1.4&#xA0;million,
 respectively.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company is
 currently subject to U.S. Federal and various state income tax
 examinations for the tax years 2013 through 2016.</font></p>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -URI http://asc.fasb.org/topic&amp;trid=2144680<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6658776640">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Common and Common Equivalent Shares<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerShareAbstract', window );"><strong>Earnings Per Share [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerShareTextBlock', window );">Common and Common Equivalent Shares</a></td>
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 <p style="margin-top:18px;margin-bottom:0px"><font style="font-family:Times New Roman" size="2"><b>12.&#xA0;&#xA0;&#xA0;&#xA0;Common and Common Equivalent
 Shares:</b></font></p>
 <p style="margin-top:6px;margin-bottom:0px; text-indent:4%">
 <font style="font-family:Times New Roman" size="2">The calculation
 of shares used in the basic and diluted net income per share
 calculation for the years ended December&#xA0;31, 2017, 2016 and
 2015 is as follows (in thousands):</font></p>
 <p style="font-size:12px;margin-top:0px;margin-bottom:0px">
 &#xA0;</p>
 <table cellspacing="0" cellpadding="0" width="92%" border="0" style="BORDER-COLLAPSE:COLLAPSE" align="center">
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 <td width="73%"></td>
 <td valign="bottom" width="3%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="3%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="3%"></td>
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 <tr style="page-break-inside:avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
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 December&#xA0;31,</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
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 <tr style="page-break-inside:avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"><font style="font-family:Times New Roman" size="1"><b>2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"><font style="font-family:Times New Roman" size="1"><b>2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1px solid #000000"><font style="font-family:Times New Roman" size="1"><b>2015</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr bgcolor="#CCEEFF" style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">Weighted average number of
 common shares outstanding</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">92,431</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
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 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
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 </tr>
 <tr style="page-break-inside:avoid">
 <td valign="top">
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 dilutive common share equivalents</font></p>
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 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">527</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">687</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">883</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="font-size:1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
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 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
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 <p style="border-top:1px solid #000000">&#xA0;</p>
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 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
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 <p style="border-top:1px solid #000000">&#xA0;</p>
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 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">Weighted average number of
 common and common equivalent shares outstanding</font></p>
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 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
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 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">93,109</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">93,960</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
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 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
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 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
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 <p style="border-top:3px double #000000">&#xA0;</p>
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 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
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 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
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 <p style="border-top:3px double #000000">&#xA0;</p>
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 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">Antidilutive securities not
 included in the diluted net income per common share
 calculation</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
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 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
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 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td nowrap="nowrap" valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">&#x2014;&#xA0;&#xA0;</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
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 <tr style="font-size:1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for earnings per share.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -URI http://asc.fasb.org/topic&amp;trid=2144383<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6769324768">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Stock Incentive Plans and Stock Purchase Plans<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract', window );"><strong>Disclosure of Compensation Related Costs, Share-based Payments [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock', window );">Stock Incentive Plans and Stock Purchase Plans</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>13.&#xA0;&#xA0;&#xA0;&#xA0;Stock Incentive Plans and Stock
 Purchase Plans:</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The
 Company&#x2019;s Amended and Restated 2008 Incentive Compensation
 Plan, as amended (the &#x201C;Amended and Restated 2008 Incentive
 Plan&#x201D;) provides for grants of stock options, stock
 appreciation rights, restricted stock, deferred stock, and other
 stock-related awards and performance awards that may be settled in
 cash, stock or other property.</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Under the
 Amended and Restated 2008 Incentive Plan, options to purchase
 shares of common stock may be granted at a price not less than the
 fair market value of the shares on the date of grant. The options
 must be exercised within 10 years from the date of grant and
 generally become exercisable on a pro rata basis over a three-year
 period from the date of grant. The Company issues new shares of its
 common stock upon exercise of its stock options. Restricted stock
 awards generally vest over periods of three years upon the
 fulfillment of specified service-based conditions and in certain
 instances performance-based conditions. Deferred stock awards
 generally vest upon the satisfaction of specified performance-based
 conditions or service-based conditions. The Company recognizes
 compensation expense related to its restricted stock and deferred
 stock awards ratably over the corresponding vesting periods. At
 December&#xA0;31, 2017, the Company had 3.4&#xA0;million shares
 available for future grants and awards under its Amended and
 Restated 2008 Incentive Plan.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Under the
 Company&#x2019;s 1996 <font style="WHITE-SPACE: nowrap">Non-Qualified</font> Employee Stock Purchase
 Plan, as amended (the &#x201C;ESPP&#x201D;), employees are permitted
 to purchase the Company&#x2019;s common stock at 85% of market value
 on January 1st, April 1st, July 1st and October 1st of each year.
 Under the Company&#x2019;s 2015 <font style="WHITE-SPACE: nowrap">Non-Qualified</font> Stock Purchase Plan (the
 &#x201C;SPP&#x201D;), certain eligible non-employee service providers
 are permitted to purchase the Company&#x2019;s common stock at 90%
 of market value on January 1st, April 1st, July 1st and October 1st
 of each year upon the SPP&#x2019;s effective date of January&#xA0;1,
 2016.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Each of the
 ESPP and the SPP provide for the issuance of an of aggregate
 2.6&#xA0;million shares of the Company&#x2019;s common stock less
 the number of shares of common stock purchased under the other
 plan. The Company recognizes stock-based compensation expense for
 the discount received by participating employees and <font style="WHITE-SPACE: nowrap">non-employee</font> service providers. During
 the year ended December&#xA0;31, 2017, 0.4&#xA0;million shares were
 issued under the ESPP and SPP. At December&#xA0;31, 2017, the
 Company had 1.9&#xA0;million shares in aggregate reserved for
 issuance under the ESPP and SPP.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 recognized $29.6&#xA0;million, $34.0&#xA0;million and
 $32.1&#xA0;million of stock-based compensation expense related to
 its stock incentive plans, the ESPP and the SPP during the years
 ended December&#xA0;31, 2017, 2016 and 2015,
 respectively.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The activity
 related to the Company&#x2019;s restricted stock and deferred stock
 awards and the corresponding weighted average grant-date fair
 values for the year ended December&#xA0;31, 2017 are as
 follows:</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="68%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Number
 of</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>Shares</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Weighted<br />
 Average&#xA0;Fair<br />
 Value</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2"><font style="WHITE-SPACE: nowrap">Non-vested</font> shares at January&#xA0;1,
 2017</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">946,329</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">66.98</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Awarded</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">637,529</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">54.22</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Forfeited</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(91,730</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">64.82</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Vested</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(451,094</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">65.00</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2"><font style="WHITE-SPACE: nowrap">Non-vested</font> shares at December&#xA0;31,
 2017</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,041,034</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">60.21</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The aggregate
 fair value of the restricted and deferred stock that vested during
 the years ended December&#xA0;31, 2017, 2016 and 2015 was
 $29.3&#xA0;million, $29.8&#xA0;million and $31.6&#xA0;million,
 respectively.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The weighted
 average grant-date fair value of restricted and deferred stock
 awards that were granted during the years ended December&#xA0;31,
 2017, 2016 and 2015 was $54.22, $67.90 and $70.44,
 respectively.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">At
 December&#xA0;31, 2017, the total stock-based compensation cost
 related to <font style="WHITE-SPACE: nowrap">non-vested</font>
 restricted and deferred stock remaining to be recognized as
 compensation expense over a weighted-average period of 1.6 years
 was $30.9&#xA0;million.</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company did
 not grant any stock options in 2017, 2016 or 2015, and all
 stock-based compensation cost related to stock options has been
 recognized. The activity and certain other information related to
 the Company&#x2019;s outstanding stock option awards for the year
 ended December&#xA0;31, 2017 are as follows:</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="51%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Number&#xA0;of</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>Stock&#xA0;
 Options</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Weighted</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>Average</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>Exercise</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>Price</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Weighted<br />
 Average<br />
 Remaining<br />
 Contractual<br />
 Term</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>(in
 years)</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Aggregate<br />
 Intrinsic</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>Value</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>(in&#xA0;millions)</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Outstanding at
 January&#xA0;1, 2017</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">410,286</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">28.33</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Exercised</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(163,944</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">29.57</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">5.5</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Outstanding and exercisable
 at December&#xA0;31, 2017</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">246,342</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">27.51</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1.5</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">6.4</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The aggregate
 intrinsic value of stock options exercised during the years ended
 December&#xA0;31, 2017, 2016 and 2015 was $5.5&#xA0;million,
 $6.8&#xA0;million and $11.3&#xA0;million, respectively.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">There were no
 excess tax benefits recognized in additional <font style="WHITE-SPACE: nowrap">paid-in</font> capital due to the adoption of
 new accounting guidance on January&#xA0;1, 2017 that requires
 excess tax benefits to be recognized in the income statement. The
 net excess tax benefit recognized in additional <font style="WHITE-SPACE: nowrap">paid-in</font> capital related primarily to
 stock options, restricted stock and deferred stock for the years
 ended December&#xA0;31, 2016 and 2015 was $4.1&#xA0;million and
 $11.6&#xA0;million, respectively. The cash proceeds received from
 the exercise of stock options for the years ended December&#xA0;31,
 2017, 2016 and 2015 were $4.8&#xA0;million, $4.7&#xA0;million and
 $6.1&#xA0;million, respectively.</font></p>
 </div><span></span>
</td>
</tr>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for compensation-related costs for equity-based compensation, which may include disclosure of policies, compensation plan details, allocation of equity compensation, incentive distributions, equity-based arrangements to obtain goods and services, deferred compensation arrangements, employee stock ownership plan details and employee stock purchase plan details.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -URI http://asc.fasb.org/topic&amp;trid=2228938<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 50<br> -URI http://asc.fasb.org/subtopic&amp;trid=2208855<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6637233152">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Common Stock Repurchase Programs<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_TextBlockAbstract', window );"><strong>Text Block [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_CommonStockRepurchasesTextBlock', window );">Common Stock Repurchase Programs</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>14.&#xA0;&#xA0;&#xA0;&#xA0;Common Stock Repurchase
 Programs:</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In July 2013,
 the Company&#x2019;s Board of Directors authorized the repurchase of
 shares of the Company&#x2019;s common stock up to an amount
 sufficient to offset the dilutive impact from the issuance of
 shares under the Company&#x2019;s equity compensation programs. The
 share repurchase program allows the Company to make open market
 purchases from <font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">time-to-time</font></font> based on general
 economic and market conditions and trading restrictions. The
 repurchase program also allows for the repurchase of shares of the
 Company&#x2019;s common stock to offset the dilutive impact from the
 issuance of shares, if any, related to the Company&#x2019;s
 acquisition program.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">During the year
 ended December&#xA0;31, 2017, the Company repurchased
 1.0&#xA0;million shares of its common stock for $70.2&#xA0;million,
 inclusive of 38,257 shares withheld to satisfy minimum statutory
 withholding obligations of $2.1&#xA0;million in connection with the
 vesting of restricted stock.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In October
 2014, the Company&#x2019;s Board of Directors authorized the
 repurchase of up to $600.0&#xA0;million of shares of the
 Company&#x2019;s common stock in addition to its existing share
 repurchase program.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In December
 2014, the Company entered into an uncollared accelerated share
 repurchase (&#x201C;ASR&#x201D;) agreement with an investment bank.
 Under the ASR agreement, the Company agreed to purchase
 $200.0&#xA0;million of its common stock in total. On
 December&#xA0;17, 2014, the Company paid a total of
 $200.0&#xA0;million to an investment bank, which in turn delivered
 to the Company 2.5&#xA0;million shares of the Company&#x2019;s
 common stock in total based on the market price of a share of
 Company common stock on December&#xA0;12, 2014. The payment was
 recorded as a reduction to the respective components of
 shareholders&#x2019; equity. The final number of shares of common
 stock that the Company may receive, or may be required to remit,
 upon settlement under the ASR agreement was to be based upon the
 average daily volume weighted-average price of the Company&#x2019;s
 common stock during the term of the ASR agreement, less a
 negotiated discount. The ASR agreement was funded by borrowings
 under the Company&#x2019;s Credit Agreement discussed in Note 10.
 Final settlement of the ASR occurred in July 2015 with the delivery
 to the Company of 0.3&#xA0;million additional shares of common
 stock. The final number of shares of common stock that the Company
 received was based upon the average daily volume weighted-average
 price of the Company&#x2019;s common stock during the term of the
 ASR agreement, less a negotiated discount.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In March 2015,
 the Company entered into a second uncollared ASR agreement with an
 investment bank. Under the ASR agreement, the Company agreed to
 purchase $200.0&#xA0;million of its common stock in total. On
 March&#xA0;16, 2015, the Company paid a total of
 $200.0&#xA0;million to an investment bank, which in turn delivered
 to the Company 2.2&#xA0;million shares of the Company&#x2019;s
 common stock in total based on the market price of a share of
 Company common stock on March&#xA0;12, 2015. The ASR agreement was
 funded by borrowings under the Company&#x2019;s Credit Agreement,
 and the payment was recorded as a reduction to the respective
 components of shareholders&#x2019; equity. Final settlement of the
 ASR occurred in October 2015 with the delivery to the Company of
 0.3&#xA0;million additional shares of common stock. The final
 number of shares of common stock that the Company received was
 based upon the average daily volume weighted-average price of the
 Company&#x2019;s common stock during the term of the ASR agreement,
 less a negotiated discount.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">During the year
 ended December&#xA0;31, 2016, the Company repurchased
 0.9&#xA0;million shares of its common stock for $61.8&#xA0;million,
 inclusive of 46,490 shares withheld to satisfy minimum stock
 withholding obligations of $3.2&#xA0;million in connection with the
 vesting of restricted stock.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 intends to utilize various methods to effect any future share
 repurchases, including, among others, open market purchases and
 accelerated share repurchase programs. The amount and timing of
 repurchases will depend upon several factors, including general
 economic and market conditions and trading restrictions.</font></p>
 </div><span></span>
</td>
</tr>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Entire disclosure of common stock repurchases.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6923739280">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Retirement Plans<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CompensationAndRetirementDisclosureAbstract', window );"><strong>Retirement Benefits [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock', window );">Retirement Plans</a></td>
<td class="text"><div>
 <p style="margin-top:18px;margin-bottom:0px"><font style="font-family:Times New Roman" size="2"><b>15.&#xA0;&#xA0;&#xA0;&#xA0;Retirement Plans:</b></font></p>
 <p style="margin-top:6px;margin-bottom:0px; text-indent:4%">
 <font style="font-family:Times New Roman" size="2">The Company
 maintains six qualified contributory savings plans as allowed under
 Section&#xA0;401(k) of the Internal Revenue Code and
 Section&#xA0;1165(e) of the Puerto Rico Income Tax Act of 1954 (the
 &#x201C;401(k) Plans&#x201D;). The 401(k) Plans permit participant
 contributions and allow elective and, in certain situations,
 <font style="white-space:nowrap">non-elective</font> Company
 contributions based on each participant&#x2019;s contribution or a
 specified percentage of eligible wages. Participants may defer a
 percentage of their annual compensation subject to the limits
 defined in the 401(k) Plans. The Company recorded expense of
 $50.7&#xA0;million, $45.2&#xA0;million and $39.7&#xA0;million for
 the years ended December&#xA0;31, 2017, 2016 and 2015,
 respectively, primarily related to the 401(k) Plans.</font></p>
 </div><span></span>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for pension and other postretirement benefits.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 715<br> -URI http://asc.fasb.org/topic&amp;trid=2235017<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6658958064">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Commitments and Contingencies<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommitmentsAndContingenciesDisclosureAbstract', window );"><strong>Commitments and Contingencies Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommitmentsAndContingenciesDisclosureTextBlock', window );">Commitments and Contingencies</a></td>
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 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>16.&#xA0;&#xA0;&#xA0;&#xA0;Commitments and
 Contingencies:</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 expects that audits, inquiries and investigations from government
 authorities and agencies will occur in the ordinary course of
 business. Such audits, inquiries and investigations and their
 ultimate resolutions, individually or in the aggregate, could have
 a material adverse effect on the Company&#x2019;s business,
 financial condition, results of operations, cash flows and the
 trading price of its common stock. The Company has not included an
 accrual for these matters as of December&#xA0;31, 2017 in its
 Consolidated Financial Statements, as the variables affecting any
 potential eventual liability depend on the currently unknown facts
 and circumstances that arise out of, and are specific to, any
 particular future audit, inquiry and investigation and cannot be
 reasonably estimated at this time.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In the ordinary
 course of business, the Company becomes involved in pending and
 threatened legal actions and proceedings, most of which involve
 claims of medical malpractice related to medical services provided
 by the Company&#x2019;s affiliated physicians. The Company&#x2019;s
 contracts with hospitals generally require the Company to indemnify
 them and their affiliates for losses resulting from the negligence
 of the Company&#x2019;s affiliated physicians. The Company may also
 become subject to other lawsuits which could involve large claims
 and significant costs. The Company believes, based upon a review of
 pending actions and proceedings, that the outcome of such legal
 actions and proceedings will not have a material adverse effect on
 its business, financial condition, results of operations, cash
 flows and the trading price of its securities. The outcome of such
 actions and proceedings, however, cannot be predicted with
 certainty and an unfavorable resolution of one or more of them
 could have a material adverse effect on the Company&#x2019;s
 business, financial condition, results of operations, cash flows
 and the trading price of its securities.</font></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Although the
 Company currently maintains liability insurance coverage intended
 to cover professional liability and certain other claims, the
 Company cannot assure that its insurance coverage will be adequate
 to cover liabilities arising out of claims asserted against it in
 the future where the outcomes of such claims are unfavorable. With
 respect to professional liability risk, the Company generally
 self-insures a portion of this risk through its wholly owned
 captive insurance subsidiary. Liabilities in excess of the
 Company&#x2019;s insurance coverage, including coverage for
 professional liability and certain other claims, could have a
 material adverse effect on the Company&#x2019;s business, financial
 condition, results of operations, cash flows and the trading price
 of its securities.</font></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 leases space for its regional, medical and business offices,
 storage space and temporary housing of medical staff. The Company
 also leases an aircraft. Rent expense for the years ended
 December&#xA0;31, 2017, 2016 and 2015 was $42.6&#xA0;million,
 $38.0&#xA0;million and $31.6&#xA0;million, respectively.</font></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Future minimum
 lease payments under <font style="WHITE-SPACE: nowrap">non-cancelable</font> operating leases as of
 December&#xA0;31, 2017 are as follows (in
 thousands):<b>&#xA0;</b></font></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt">
 <font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="68%" align="center" border="0">
 <tr>
 <td width="83%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2018</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">34,337</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2019</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">24,178</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2020</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">16,633</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2021</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">12,065</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2022</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8,125</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Thereafter</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">9,934</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">105,272</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
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 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <td>&#xA0;</td>
 </tr>
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</td>
</tr>
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<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Selected Quarterly Financial Information<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
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 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The following
 tables set forth a summary of the Company&#x2019;s selected
 quarterly financial information for each of the four quarters ended
 December&#xA0;31, 2017 and 2016 (in thousands, except for per share
 data):</font></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt">
 <font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></p>
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 <td></td>
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 <td></td>
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 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="14" align="center"><b>2017 Quarters</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>First</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>Second</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>Third</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>Fourth</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net revenue</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">835,597</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">842,944</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">868,951</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">910,820</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
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 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Operating expenses:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Practice salaries and benefits</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">572,385</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">561,418</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">586,476</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">617,455</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Practice supplies and other operating expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">27,796</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">30,872</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">29,497</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">32,353</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 General and administrative expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">103,765</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">103,015</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">101,430</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">108,895</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Depreciation and amortization</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,614</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,735</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,116</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26,414</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total operating expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">729,560</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">721,040</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">742,519</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">785,117</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income from operations</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">106,037</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">121,904</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">126,432</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">125,703</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Investment and other income</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">576</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">365</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">235</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,777</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Interest expense</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17,752</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(18,535</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(18,428</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(19,844</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Equity (losses) in earnings of unconsolidated affiliate</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">797</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">689</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(240</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(294</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total <font style="WHITE-SPACE: nowrap">non-operating</font>
 expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(16,379</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17,481</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(18,433</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17,361</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income before income taxes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">89,658</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">104,423</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">107,999</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">108,342</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income tax (provision) benefit</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(34,967</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(40,725</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(42,119</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">27,761</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income attributable to MEDNAX, Inc.</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">54,691</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">63,698</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">65,880</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">136,103</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Per common and common equivalent share data (1):</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income attributable to MEDNAX, Inc.:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Basic</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.59</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.69</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.71</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1.47</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Diluted</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.59</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.69</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.71</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1.46</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Weighted average common shares:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Basic</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,360</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,181</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,589</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,756</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Diluted</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,143</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,812</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,881</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,159</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt">
 <font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="100%" border="0">
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top" width="4%" align="left">(1)</td>
 <td valign="top" align="left">Basic and diluted per share amounts
 are computed for each of the periods presented. Accordingly, the
 sum of the quarterly per share amounts may not agree with the full
 year amount.</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px">
 <font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="100%" align="center" border="0">
 <tr>
 <td width="64%"></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="14" align="center"><b>2016 Quarters</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>First</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>Second</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>Third</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>Fourth</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net revenue</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">752,624</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">771,759</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">828,006</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">830,770</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Operating expenses:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Practice salaries and benefits</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">491,811</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">484,625</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">521,832</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">532,952</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Practice supplies and other operating expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">27,046</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26,992</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">31,641</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">32,737</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 General and administrative expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">89,950</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,116</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,457</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">97,049</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Depreciation and amortization</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">19,584</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">20,241</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">24,185</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,254</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total operating expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">628,391</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">623,974</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">671,115</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">687,992</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income from operations</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">124,233</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">147,785</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">156,891</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">142,778</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Investment and other income</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">618</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">410</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">221</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">770</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Interest expense</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(14,463</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(15,058</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17,215</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(16,356</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Equity in earnings of unconsolidated affiliate</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">794</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">789</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">796</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">806</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total <font style="WHITE-SPACE: nowrap">non-operating</font>
 expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(13,051</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(13,859</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(16,198</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(14,780</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income before income taxes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">111,182</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">133,926</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">140,693</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">127,998</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income tax provision</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(43,411</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(51,601</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(44,272</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(49,919</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">67,771</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">82,325</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">96,421</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">78,079</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net loss attributable to noncontrolling interests</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">128</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">102</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">88</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income attributable to MEDNAX, Inc.</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">67,899</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">82,427</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">96,509</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">78,079</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Per common and common equivalent share data (2):</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income attributable to MEDNAX, Inc.:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Basic</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.74</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.89</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1.04</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.84</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Diluted</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.73</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.89</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1.04</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.84</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
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 &#xA0;</p>
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 &#xA0;</p>
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 &#xA0;</p>
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 <td valign="bottom">&#xA0;&#xA0;</td>
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 <td valign="bottom"></td>
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 &#xA0;</p>
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 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 &#xA0;</p>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for quarterly financial data. Includes, but is not limited to, tabular presentation of financial information for fiscal quarters, effect of year-end adjustments, and an explanation of matters or transactions that affect comparability of the information.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 270<br> -URI http://asc.fasb.org/topic&amp;trid=2126967<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6658828832">
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<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Schedule II: Valuation and Qualifying Accounts<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfValuationAndQualifyingAccountsDisclosureTextBlock', window );">Schedule II: Valuation and Qualifying Accounts</a></td>
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 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 24pt" align="center"><font style="FONT-FAMILY: Times New Roman" size="2"><b>MEDNAX, INC.</b></font></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 0pt" align="center"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Schedule II: Valuation and Qualifying
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 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="10" align="center"><b>Years Ended
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 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Allowance for contractual adjustments and uncollectibles:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
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 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Balance at beginning of year</p>
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 <td valign="bottom">$</td>
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 Accounts receivable contractual adjustments and write-offs (net of
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 <td valign="bottom" align="right">(8,223,648</td>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Balance at end of year</p>
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 <td valign="bottom">$</td>
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 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
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 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom"></td>
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 &#xA0;</p>
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 &#xA0;</p>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for any allowance and reserve accounts (their beginning and ending balances, as well as a reconciliation by type of activity during the period). Alternatively, disclosure of the required information may be within the footnotes to the financial statements or a supplemental schedule to the financial statements.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -URI http://asc.fasb.org/topic&amp;trid=2122369<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6763423632">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Summary of Significant Accounting Policies (Policies)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccountingPoliciesAbstract', window );"><strong>Accounting Policies [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConsolidationPolicyTextBlock', window );">Principles of Presentation</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt">
 <b>Principles of Presentation</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 The consolidated financial statements include all the accounts of
 the Company and its subsidiaries combined with the accounts of the
 affiliated professional contractors with which the Company
 currently has specific management arrangements. The Company&#x2019;s
 agreements with affiliated professional contractors provide that
 the term of the arrangements are in most cases permanent, subject
 only to termination by the Company, except in the case of gross
 negligence, fraud or bankruptcy of the Company. The Company has the
 right to receive income, both as ongoing fees and as proceeds from
 the sale of its interest in the Company&#x2019;s affiliated
 professional contractors, in an amount that fluctuates based on the
 performance of the affiliated professional contractors and the
 change in the fair value of the Company&#x2019;s interest in the
 affiliated professional contractors. The Company has exclusive
 responsibility for the provision of all <font style="WHITE-SPACE: nowrap">non-medical</font> services required for the
 <font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">day-to-day</font></font> operation and
 management of the Company&#x2019;s affiliated professional
 contractors and establishes the guidelines for the employment and
 compensation of the physicians. In addition, the agreements provide
 that the Company has the right, but not the obligation, to
 purchase, or to designate a person(s) to purchase, the stock of the
 Company&#x2019;s affiliated professional contractors for a nominal
 amount. Separately, in its sole discretion, the Company has the
 right to assign its interest in the agreements. Based upon the
 provisions of these agreements, the Company has determined that the
 affiliated professional contractors are variable interest entities
 and that the Company is the primary beneficiary as defined in the
 accounting guidance for consolidation. All significant intercompany
 and interaffiliate accounts and transactions have been
 eliminated.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 The Company is a partner in a joint venture in which it owns a
 37.5% economic interest. The Company accounts for this joint
 venture under the equity method of accounting because the Company
 exercises significant influence over, but does not control, this
 entity. On March&#xA0;31, 2017, the Company sold its 75% economic
 interest in a second joint venture. The Company had a management
 agreement with the joint venture and, based on the terms of the
 agreement, the Company had determined that the joint venture was a
 variable interest entity for which the Company was the primary
 beneficiary. Accordingly, through the date of the sale, the
 financial results of the joint venture were fully consolidated into
 the Company&#x2019;s operating results and the equity interests of
 the outside investor in the equity and results of operations of
 this consolidated entity were accounted for and presented as
 noncontrolling interests. See Note 6 for more information regarding
 the deconsolidation of this joint venture.</p>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock', window );">Recently Adopted Accounting Pronouncements</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Recently Adopted
 Accounting Pronouncements</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In January
 2017, the accounting guidance related to goodwill impairment was
 amended to remove step two of the impairment test that requires a
 hypothetical purchase price allocation in order to measure the
 amount of any impairment. Under the new guidance, only a
 single-step quantitative test is required and any goodwill
 impairment will now be the amount by which a reporting unit&#x2019;s
 carrying value exceeds its fair value. The new guidance does not
 amend the optional alternative to perform a qualitative assessment
 to determine if a quantitative goodwill impairment test is
 necessary. The Company early adopted this accounting guidance on
 December&#xA0;31, 2017 as permitted. The adoption of this guidance
 did not have an impact on the Company&#x2019;s Consolidated
 Financial Statements.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In January
 2017, the accounting guidance related to business combinations was
 amended to clarify the definition of a business. The Company early
 adopted this accounting guidance on December&#xA0;31, 2017 as
 permitted. The adoption of this guidance did not have an impact on
 the Company&#x2019;s Consolidated Financial Statements.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In August 2016
 and November 2016, the accounting guidance related to the statement
 of cash flows was amended with the intent of reducing diversity in
 practice as to the classification of certain transactions in the
 statement of cash flows. The Company early adopted this accounting
 guidance on December&#xA0;31, 2017 as permitted. The adoption of
 this guidance resulted in the inclusion of restricted cash balances
 in the Company&#x2019;s Consolidated Statements of Cash
 Flows.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In March 2016,
 the accounting guidance related to various aspects of share-based
 payment transactions was amended, including income tax
 consequences, classification of awards as either equity or
 liabilities, and classification on the statement of cash flows.
 Under the new guidance, excess tax benefits and deficiencies are to
 be recognized as income tax benefits or expenses in the income
 statement as discrete items in the reporting period in which they
 occur instead of increases or decreases to shareholders&#x2019;
 equity. Excess tax benefits should be classified along with other
 income tax cash flows as operating activities. With regard to
 forfeitures, the entity may make an entity-wide accounting policy
 election to either estimate the number of awards that are expected
 to vest or account for forfeitures when they occur. This guidance
 became effective for the Company on January&#xA0;1, 2017. The
 Company adopted this guidance prospectively for both the income
 statement and statement of cash flows, and the adoption of this
 guidance did not have a material impact on the Company&#x2019;s
 Consolidated Financial Statements. The Company continues to
 estimate forfeitures based on the number of awards that are
 expected to vest.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock', window );">New Accounting Pronouncements</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>New Accounting
 Pronouncements</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In February
 2016, the accounting guidance related to leases was issued that
 will require an entity to recognize leased assets and the rights
 and obligations created by those leased assets on the balance sheet
 and to disclose key information about the entity&#x2019;s leasing
 arrangements. This guidance will become effective for the Company
 on January&#xA0;1, 2019, with early adoption permitted. The Company
 expects that the adoption of this guidance will have a material
 impact on its Consolidated Balance Sheets and related disclosures,
 resulting from the recognition of significant right of use assets
 and related liabilities primarily related to its operating lease
 arrangements for space in hospitals and certain other facilities
 for its business and medical offices. The Company is in the process
 of reviewing its existing lease portfolio and accumulating all of
 the necessary information required to properly account for leases
 under the new guidance.&#xA0;Additionally, the Company is assessing
 system requirements, required changes to its processes and internal
 control implications to ensure the Company will meet the reporting
 and disclosure requirements. The Company&#x2019;s evaluation of this
 guidance and its impacts are expected to continue through the third
 quarter of 2018.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In May 2014,
 the accounting guidance related to revenue recognition was amended
 to outline a single, comprehensive model for accounting for revenue
 from contracts with customers. The core principle of the new
 accounting guidance is to require an entity to recognize as revenue
 the amount that reflects the consideration to which it expects to
 be entitled in exchange for goods or services as it transfers
 control to its customers.&#xA0;The new guidance will become
 effective for the Company on January&#xA0;1, 2018. The
 Company&#x2019;s current revenue recognition policies for its
 significant revenue streams materially comply with the amended
 guidance. The primary change for healthcare providers under the new
 guidance is the requirement to report the allowance for
 uncollectibles associated with patient responsibility amounts as a
 reduction in net revenue as opposed to bad debt expense as a
 component of operating expenses. The Company has historically
 included the allowance for uncollectibles associated with patient
 responsibility amounts with its allowance for contractual
 adjustments as a reduction in net revenue as such amounts are not
 material. Accordingly, the adoption of this guidance will not have
 an impact on our Consolidated Financial Statements.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UseOfEstimates', window );">Accounting Estimates and Assumptions</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Accounting Estimates and
 Assumptions</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The preparation
 of financial statements in conformity with accounting principles
 generally accepted in the United States (&#x201C;GAAP&#x201D;)
 requires management to make estimates and assumptions that affect
 the reported amounts of assets and liabilities and disclosure of
 contingent assets and liabilities at the date of the financial
 statements and the reported amounts of revenue and expenses during
 the reporting periods. Significant estimates and assumptions are
 involved in the calculation of the Company&#x2019;s allowance for
 contractual adjustments and uncollectibles on accounts receivable,
 liabilities for self- insured amounts and claims incurred but not
 reported related to the Company&#x2019;s professional liability
 risks and the fair value of goodwill. Actual results could differ
 from those estimates.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingPolicyPolicyTextBlock', window );">Segment Reporting</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Segment
 Reporting</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The results of
 the Company&#x2019;s operations are aggregated into a single
 reportable segment for purposes of presenting financial information
 in accordance with the accounting guidance for segment
 reporting.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The following
 table summarizes the Company&#x2019;s net revenue by service line
 (in percentages):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="75%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Years&#xA0;Ended&#xA0;December&#xA0;31,</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2015</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Anesthesiology</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">38</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">39</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">37</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Neonatology and other
 pediatric subspecialties</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">37</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">39</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">44</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Maternal-fetal
 medicine</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">8</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">8</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">9</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Radiology and
 teleradiology</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">8</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">6</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">4</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Management
 services</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">6</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">5</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">2</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Pediatric
 cardiology</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">3</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">3</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">%&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">4</font></td>
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 </table>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RevenueRecognitionPolicyTextBlock', window );">Revenue Recognition</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Revenue
 Recognition</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Patient service
 revenue is recognized at the time services are provided by the
 Company&#x2019;s affiliated physicians. Almost all of the
 Company&#x2019;s patient service revenue is reimbursed by
 government-sponsored healthcare programs and third-party insurance
 payors. Payments for services rendered to the Company&#x2019;s
 patients are generally less than billed charges. The Company
 monitors its revenue and receivables from these sources and records
 an estimated contractual allowance to properly account for the
 anticipated differences between billed and reimbursed
 amounts.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Accordingly,
 patient service revenue is presented net of an estimated provision
 for contractual adjustments and uncollectibles. The Company
 estimates allowances for contractual adjustments and uncollectibles
 on accounts receivable based upon historical experience and other
 factors, including days sales outstanding (&#x201C;DSO&#x201D;) for
 accounts receivable, evaluation of expected adjustments and
 delinquency rates, past adjustments and collection experience in
 relation to amounts billed, an aging of accounts receivable,
 current contract and reimbursement terms, changes in payor mix and
 other relevant information. Contractual adjustments result from the
 difference between the physician rates for services performed and
 the reimbursements by government-sponsored healthcare programs and
 insurance companies for such services.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In addition,
 the Company generates revenue for services rendered under various
 coding and billing contracts. Contract terms are specific to each
 customer and may include a combination of a flat fee for coding of
 medical charts, a fixed fee per patient visit as well as a
 percentage of cash collections received by the providers. Revenue
 for flat and fixed fee arrangements is recognized in the month the
 coding occurs or the patient visit occurs. Revenue for percentage
 fees are recognized in the month that cash is collected for
 customers from payors. Revenue recorded for these services during
 2017 were immaterial.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Accounts
 receivable are primarily amounts due under <font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">fee-for-service</font></font> contracts from
 third-party payors, such as insurance companies, self-insured
 employers and patients and government-sponsored healthcare programs
 geographically dispersed throughout the United States and its
 territories. Concentration of credit risk relating to accounts
 receivable is limited by the number, diversity and geographic
 dispersion of the business units managed by the Company, as well as
 by the large number of patients and payors, including the various
 governmental agencies in the states in which the Company provides
 services. Receivables from government agencies made up
 approximately 17% of net accounts receivable at December&#xA0;31,
 2017 and 2016.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CashAndCashEquivalentsPolicyTextBlock', window );">Cash and Cash Equivalents</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Cash and Cash
 Equivalents</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Cash
 equivalents are defined as all highly liquid financial instruments
 with maturities of 90 days or less from the date of purchase. The
 Company&#x2019;s cash equivalents typically consist of demand
 deposits, amounts on deposit in money market accounts, and funds
 invested in overnight repurchase agreements. Cash equivalent
 balances may, at certain times, exceed federally insured
 limits.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Certain cash
 equivalents carried by the Company are subject to the fair value
 provisions of the accounting guidance for fair value measurements.
 See &#x201C;Fair Value Measurements&#x201D; below.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy', window );">Restricted Cash</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Restricted
 Cash</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Restricted cash
 consists of funds in escrow related to a potential future payment
 for contingent consideration for an acquisition completed during
 the year ended December&#xA0;31, 2017. See Note 6 for more
 information regarding the underlying contingent consideration
 arrangement.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InvestmentPolicyTextBlock', window );">Investments</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Investments</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Investments
 consist of municipal debt securities, federal home loan securities
 and certificates of deposit. Investments with remaining maturities
 of less than one year are classified as short-term investments.
 Investments classified as long-term have maturities of one year to
 six years.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 intends and has the ability to hold its securities to maturity, and
 therefore carries such investments at amortized cost in accordance
 with the provisions of the accounting guidance for investments in
 debt securities.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentPolicyTextBlock', window );">Property and Equipment</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Property and
 Equipment</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Property and
 equipment are recorded at original purchase cost. Depreciation of
 property and equipment is computed using the straight-line method
 over the estimated useful lives of the underlying assets. Estimated
 useful lives are generally 30 years for buildings; three to seven
 years for medical equipment, computer equipment, software and
 furniture; and the lesser of the useful life or the remaining lease
 term for leasehold improvements and capital leases. Upon sale or
 retirement of property and equipment, the related cost and
 accumulated depreciation are eliminated from the respective
 accounts and any resulting gain or loss is included in
 earnings.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationsPolicy', window );">Business Acquisitions</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Business
 Acquisitions</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 accounts for all business acquisitions at fair value and expenses
 acquisition costs as they are incurred. Any identifiable assets
 acquired and liabilities assumed are recognized and measured at
 their respective fair values on the acquisition date. If
 information about facts and circumstances existing as of the
 acquisition date is incomplete at the end of the reporting period
 in which a business acquisition occurs, the Company will report
 provisional amounts for the items for which the accounting is
 incomplete. The measurement period ends once the Company receives
 sufficient information to finalize the fair values; however, the
 period will not exceed one year from the acquisition date. Prior to
 January&#xA0;1, 2016, any material adjustments recognized during
 the measurement period were required to be reflected
 retrospectively in the Consolidated Financial Statements of the
 subsequent period. Beginning on January&#xA0;1, 2016, any
 adjustments to provisional amounts that are identified during the
 measurement period are required to be recognized in the reporting
 period in which the adjustment amounts are determined.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In connection
 with certain acquisitions, the Company enters into agreements to
 pay additional amounts in cash or common stock based on the
 achievement of certain performance measures for up to five years
 ending after the acquisition dates. The Company measures this
 contingent consideration at fair value at the acquisition date and
 records such contingent consideration as a liability or equity on
 the Company&#x2019;s Consolidated Balance Sheets on the acquisition
 date. The fair value of each contingent consideration liability is
 remeasured at each reporting period with any change in fair value
 recognized as income or expense within operations in the
 Company&#x2019;s Consolidated Statements of Income. See Note 6 for
 more information on the Company&#x2019;s business
 acquisitions.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock', window );">Goodwill and Other Intangible Assets</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Goodwill and Other
 Intangible Assets</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 records acquired assets and assumed liabilities at their respective
 fair values under the acquisition method of accounting. Goodwill
 represents the excess of purchase price over the fair value of the
 net assets acquired. Intangible assets with finite lives,
 principally physician and hospital agreements, customer
 relationships, patented technology and trade names, are recognized
 apart from goodwill at the time of acquisition based on the
 contractual-legal and separability criteria established in the
 accounting guidance. Intangible assets with finite lives are
 amortized on either an accelerated basis based on the annual
 undiscounted economic cash flows associated with the particular
 intangible asset or on a straight-line basis over their estimated
 useful lives. Intangible assets with finite lives are amortized
 over periods of one to 20 years.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Goodwill is
 tested for impairment at a reporting unit level on at least an
 annual basis in accordance with the subsequent measurement
 provisions of the accounting guidance for goodwill. The Company
 defines a reporting unit based upon its management structure for
 services provided in specific regions of the United States. The
 Company early adopted new accounting guidance in 2017 that requires
 only a single-step quantitative test with any goodwill impairment
 measured as the amount by which a reporting unit&#x2019;s carrying
 value exceeds its fair value. The Company uses income and
 market-based valuation approaches to determine the fair value of
 its reporting units. These approaches focus on discounted cash
 flows and market multiples based on the Company&#x2019;s market
 capitalization to derive the fair value of a reporting unit. The
 Company also considers the economic outlook for the healthcare
 services industry and various other factors during the testing
 process, including hospital and physician contract changes, local
 market developments, changes in third-party payor payments, and
 other publicly available information. The Company completed annual
 impairment tests in the third quarter of each of 2017, 2016 and
 2015 and determined that goodwill was not impaired in any of the
 three years.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock', window );">Long-Lived Assets</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Long-Lived
 Assets</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company is
 required to evaluate long-lived assets, including intangible assets
 subject to amortization, whenever events or changes in
 circumstances indicate that the carrying value of the assets may
 not be fully recoverable. The recoverability of such assets is
 measured by a comparison of the carrying value of the assets to the
 future undiscounted cash flows before interest charges to be
 generated by the assets. If long-lived assets are impaired, the
 impairment to be recognized is measured as the excess of the
 carrying value over the fair value. Long-lived assets held for
 disposal are reported at the lower of the carrying value or fair
 value less disposal costs. The Company does not believe there are
 any indicators that would require an adjustment to such assets or
 their estimated periods of recovery at December&#xA0;31, 2017
 pursuant to current accounting standards.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_CommonStockShareRepurchasesPolicyTextBlock', window );">Common Stock Repurchases</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Common Stock
 Repurchases</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 repurchases shares of its common stock as authorized from time to
 time by its Board of Directors. The Company treats repurchased
 shares of its common stock as retired as any repurchased shares
 become authorized but unissued shares. The reacquisition cost of
 repurchased shares is recorded as a reduction in the respective
 components of shareholders&#x2019; equity.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_ProfessionalLiabilityCoveragePolicyTextBlock', window );">Professional Liability Coverage</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Professional Liability
 Coverage</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 maintains professional liability insurance policies with
 third-party insurers generally on a claims-made basis, subject to
 deductibles or self-insured retention, exclusions and other
 restrictions. The Company&#x2019;s self-insured retention under its
 professional liability insurance program is maintained primarily
 through a wholly owned captive insurance subsidiary. The Company
 records an estimate of liabilities for self-insured amounts and
 claims incurred but not reported based on an actuarial valuation
 using historical loss information, claim emergence patterns and
 various actuarial assumptions. Liabilities for claims incurred but
 not reported are not discounted.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxPolicyTextBlock', window );">Income Taxes</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Income
 Taxes</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 records deferred income taxes using the liability method, whereby
 deferred tax assets and liabilities are determined based on the
 difference between the financial statement and tax bases of assets
 and liabilities using enacted tax rates in effect for the year in
 which the differences are expected to reverse. If it is more likely
 than not that all or a portion of deferred tax assets will not be
 realized, a valuation allowance is provided against such deferred
 tax assets. In making such determination, the Company considers all
 available positive and negative evidence, including future
 reversals of existing taxable temporary differences, projected
 future taxable income, <font style="WHITE-SPACE: nowrap">tax-planning</font> strategies, and results
 of recent operations.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The accounting
 guidance for uncertain tax positions prescribes a recognition
 threshold and measurement attribute for financial statement
 recognition and measurement of a tax position taken or expected to
 be taken in a tax return. The guidance also requires policy
 disclosures regarding penalties and interest and extensive
 disclosures regarding increases and decreases in uncertain tax
 positions as a result of tax positions taken in a current or prior
 period, settlements with taxing authorities and any lapse of an
 applicable statute of limitations. Additional qualitative
 discussion is required for any tax position that may result in a
 significant increase or decrease in uncertain tax positions within
 a <font style="WHITE-SPACE: nowrap">12-month</font> period from the
 Company&#x2019;s reporting date.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy', window );">Stock Incentive Plans</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Stock Incentive
 Plans</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 grants stock-based awards consisting primarily of restricted stock
 to key employees under its Amended and Restated 2008 Incentive
 Compensation Plan, as amended. The Company measures the cost of
 employee services received in exchange for stock-based awards based
 on grant-date fair value and allocates the resulting compensation
 expense over the corresponding requisite service period using the
 graded vesting attribution method. The Company also performs
 analyses to estimate forfeitures of stock-based awards on an annual
 basis and adjusts the estimates as necessary based on the number of
 awards that ultimately vest.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerSharePolicyTextBlock', window );">Net Income Per Common Share</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Net Income Per Common
 Share</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Basic net
 income per common share is calculated by dividing net income by the
 weighted average number of common shares outstanding during the
 period. Diluted net income per common share is calculated by
 dividing net income by the weighted average number of common and
 potential common shares outstanding during the period. Potential
 common shares consist of outstanding restricted stock, deferred
 stock and stock options and is calculated using the treasury stock
 method. On January&#xA0;1, 2017, the Company adopted new accounting
 guidance that no longer permits the Company to include the assumed
 excess tax benefits related to the potential exercise or vesting of
 its stock-based awards in the treasury stock method computation.
 The impact on the weighted average number of common and common
 equivalent shares outstanding from excluding such assumed excess
 tax benefits for the year ended December&#xA0;31, 2017 was not
 material. See &#x201C;Recently Adopted Accounting
 Pronouncements&#x201D; above for additional information on the
 adoption of the new accounting guidance.</font></p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FairValueOfFinancialInstrumentsPolicy', window );">Fair Value Measurements</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 18px"><font style="FONT-FAMILY: Times New Roman" size="2"><b>Fair Value
 Measurements</b></font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 6px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In accordance
 with the accounting guidance for fair value measurements and
 disclosures, the Company carries its money market funds included in
 cash and cash equivalents at fair value. In accordance with the
 three-tier fair value hierarchy under this guidance, the Company
 determined the fair value using quoted market prices, a
 Level&#xA0;1 input as defined under the accounting guidance for
 fair value measurements. At December&#xA0;31, 2017 and 2016, the
 Company&#x2019;s money market funds had a fair value of
 $9.2&#xA0;million and $12.4&#xA0;million, respectively.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The Company
 also carries the cash surrender value of life insurance related to
 its deferred compensation arrangements at fair value. The
 investments underlying the life insurance contracts consist
 primarily of exchange-traded equity securities and mutual funds
 with quoted prices in active markets. In accordance with the
 three-tier fair value hierarchy, the Company determined the fair
 value using the cash surrender value of the life insurance, a
 Level&#xA0;2 input as defined under the accounting guidance for
 fair value measurements. At December&#xA0;31, 2017 and 2016, the
 Company&#x2019;s cash surrender value of life insurance had a fair
 value of $15.6&#xA0;million and $15.8&#xA0;million,
 respectively.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">In addition,
 the Company carries its contingent consideration liabilities
 related to acquisitions at fair value. In accordance with the
 three-tier fair value hierarchy, the Company determined the fair
 value of its contingent consideration liabilities using the income
 approach with assumed discount rates and payment probabilities. The
 income approach uses Level&#xA0;3, or unobservable inputs as
 defined under the accounting guidance for fair value measurements.
 At December&#xA0;31, 2017 and 2016, the Company&#x2019;s contingent
 consideration liabilities had a fair value of $30.5&#xA0;million
 and $17.3&#xA0;million, respectively. See Note 6 for more
 information regarding the Company&#x2019;s contingent consideration
 liabilities.</font></p>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The carrying
 amounts of cash equivalents, short-term investments, accounts
 receivable and accounts payable and accrued expenses approximate
 fair value due to the short maturities of the respective
 instruments. The carrying values of long-term investments, line of
 credit, variable rate long-term debt and capital lease obligations
 approximate fair value. If the Company&#x2019;s investments were
 measured at fair value, they would be categorized as Level&#xA0;2
 in the fair value hierarchy. If the Company&#x2019;s line of credit
 and variable long-term debt were measured at fair value, they would
 be categorized as Level&#xA0;2 in the fair value hierarchy. See
 Note 10 for information regarding the fair value of the
 Company&#x2019;s 5.25% senior unsecured notes due 2023 (the
 &#x201C;2023 Notes&#x201D;).</font></p>
 </div><span></span>
</td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Common stock share repurchases policy.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Professional liability coverage policy.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Recently adopted accounting pronouncements policy.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for completed business combinations (purchase method, acquisition method or combination of entities under common control). This accounting policy may include a general discussion of the purchase method or acquisition method of accounting (including for example, the treatment accorded contingent consideration, the identification of assets and liabilities, the purchase price allocation process, how the fair values of acquired assets and liabilities are determined) and the entity's specific application thereof. An entity that acquires another entity in a leveraged buyout transaction generally discloses the accounting policy followed by the acquiring entity in determining the basis used to value its interest in the acquired entity, and the rationale for that accounting policy.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 10<br> -Section 05<br> -Paragraph 4<br> -Subparagraph (a)-(d)<br> -URI http://asc.fasb.org/extlink&amp;oid=6909625&amp;loc=d3e227-128457<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationsPolicy</td>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for cash and cash equivalents, including the policy for determining which items are treated as cash equivalents. Other information that may be disclosed includes (1) the nature of any restrictions on the entity's use of its cash and cash equivalents, (2) whether the entity's cash and cash equivalents are insured or expose the entity to credit risk, (3) the classification of any negative balance accounts (overdrafts), and (4) the carrying basis of cash equivalents (for example, at cost) and whether the carrying amount of cash equivalents approximates fair value.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(1))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 305<br> -SubTopic 10<br> -Section 05<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6375392&amp;loc=d3e26790-107797<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4273-108586<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CashAndCashEquivalentsPolicyTextBlock</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Entity's cash and cash equivalents accounting policy with respect to restricted balances.  Restrictions may include legally restricted deposits held as compensating balances against short-term borrowing arrangements, contracts entered into with others, or company statements of intention with regard to particular deposits; however, time deposits and short-term certificates of deposit are not generally included in legally restricted deposits.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-03(1)(a))<br> -URI http://asc.fasb.org/extlink&amp;oid=6876686&amp;loc=d3e534808-122878<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 305<br> -SubTopic 10<br> -Section 05<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6375392&amp;loc=d3e26790-107797<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(1))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4273-108586<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy regarding (1) the principles it follows in consolidating or combining the separate financial statements, including the principles followed in determining the inclusion or exclusion of subsidiaries or other entities in the consolidated or combined financial statements and (2) its treatment of interests (for example, common stock, a partnership interest or other means of exerting influence) in other entities, for example consolidation or use of the equity or cost methods of accounting.  The accounting policy may also address the accounting treatment for intercompany accounts and transactions, noncontrolling interest, and the income statement treatment in consolidation for issuances of stock by a subsidiary.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=84161450&amp;loc=d3e5614-111684<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section S99<br> -Paragraph 3<br> -Subparagraph (SX 210.3A-03)<br> -URI http://asc.fasb.org/extlink&amp;oid=27015204&amp;loc=d3e355100-122828<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.3A-02)<br> -URI http://asc.fasb.org/extlink&amp;oid=27015204&amp;loc=d3e355033-122828<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for computing basic and diluted earnings or loss per share for each class of common stock and participating security. Addresses all significant policy factors, including any antidilutive items that have been excluded from the computation and takes into account stock dividends, splits and reverse splits that occur after the balance sheet date of the latest reporting period but before the issuance of the financial statements.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3550-109257<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3550-109257<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3630-109257<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for determining the fair value of financial instruments.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 825<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=77997519&amp;loc=d3e13279-108611<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 820<br> -SubTopic 10<br> -Section 60<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=7493716&amp;loc=d3e21868-110260<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FairValueOfFinancialInstrumentsPolicy</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for goodwill and intangible assets. This accounting policy also may address how an entity assesses and measures impairment of goodwill and intangible assets.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16265-109275<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=35741047&amp;loc=d3e13816-109267<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for recognizing and measuring the impairment of long-lived assets. An entity also may disclose its accounting policy for long-lived assets to be sold. This policy excludes goodwill and intangible assets.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SAB Topic 5.CC)<br> -URI http://asc.fasb.org/extlink&amp;oid=27011434&amp;loc=d3e125687-122742<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section 05<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=64802544&amp;loc=d3e202-110218<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for income taxes, which may include its accounting policies for recognizing and measuring deferred tax assets and liabilities and related valuation allowances, recognizing investment tax credits, operating loss carryforwards, tax credit carryforwards, and other carryforwards, methodologies for determining its effective income tax rate and the characterization of interest and penalties in the financial statements.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 19<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32840-109319<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 30<br> -Section 05<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=65884525&amp;loc=d3e40913-109327<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 954<br> -SubTopic 740<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6491622&amp;loc=d3e9504-115650<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 17<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32809-109319<br><br>Reference 6: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 45<br> -Paragraph 25<br> -URI http://asc.fasb.org/extlink&amp;oid=84176650&amp;loc=d3e32247-109318<br><br>Reference 7: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -URI http://asc.fasb.org/extlink&amp;oid=84176650&amp;loc=d3e32280-109318<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxPolicyTextBlock</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for investments in financial assets, including marketable securities (debt and equity securities with readily determinable fair values), investments accounted for under the equity method and cost method, securities borrowed and loaned, and repurchase and resale agreements. For marketable securities, the disclosure may include the entity's accounting treatment for transfers between investment categories and how the fair values for such securities are determined. Also, for all investments, an entity may describe its policy for assessing, recognizing and measuring impairment of the investment.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 323<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -Subparagraph (a)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=66011266&amp;loc=d3e33918-111571<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 50<br> -Paragraph 6<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=82897076&amp;loc=d3e27290-111563<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.2,12)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB Topic 5.M)<br> -URI http://asc.fasb.org/extlink&amp;oid=65877573&amp;loc=d3e87990-122713<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 6: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 325<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=75025870&amp;loc=d3e40691-111596<br><br>Reference 7: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 825<br> -SubTopic 10<br> -Section 50<br> -Paragraph 10<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=77997519&amp;loc=d3e13433-108611<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy pertaining to new accounting pronouncements that may impact the entity's financial reporting. Includes, but is not limited to, quantification of the expected or actual impact.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for long-lived, physical assets used in the normal conduct of business and not intended for resale. Includes, but is not limited to, basis of assets, depreciation and depletion methods used, including composite deprecation, estimated useful lives, capitalization policy, accounting treatment for costs incurred for repairs and maintenance, capitalized interest and the method it is calculated, disposals and impairments.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.13(a))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for revenue recognition. If the entity has different policies for different types of revenue transactions, the policy for each material type of transaction is generally disclosed. If a sales transaction has multiple element arrangements (for example, delivery of multiple products, services or the rights to use assets) the disclosure may indicate the accounting policy for each unit of accounting as well as how units of accounting are determined and valued. The disclosure may encompass important judgment as to appropriateness of principles related to recognition of revenue. The disclosure also may indicate the entity's treatment of any unearned or deferred revenue that arises from the transaction.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18823-107790<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 605<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB Topic 13.B.Q1)<br> -URI http://asc.fasb.org/extlink&amp;oid=65893310&amp;loc=d3e214044-122780<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18726-107790<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RevenueRecognitionPolicyTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for segment reporting.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SegmentReportingPolicyPolicyTextBlock</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<tr>
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<td><strong> Period Type:</strong></td>
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</table>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for stock option and stock incentive plans. This disclosure may include (1) the types of stock option or incentive plans sponsored by the entity (2) the groups that participate in (or are covered by) each plan (3) significant plan provisions and (4) how stock compensation is measured, and the methodologies and significant assumptions used to determine that measurement.</p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for the use of estimates in the preparation of financial statements in conformity with generally accepted accounting principles.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=84177426&amp;loc=d3e6061-108592<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -URI http://asc.fasb.org/extlink&amp;oid=84177426&amp;loc=d3e6143-108592<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=84177426&amp;loc=d3e6132-108592<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6769265856">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Summary of Significant Accounting Policies (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
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 <font style="FONT-FAMILY: Times New Roman" size="2">The following
 table summarizes the Company&#x2019;s net revenue by service line
 (in percentages):</font></p>
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 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">3</font></td>
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 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">4</font></td>
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 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">100</font></td>
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 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the profit or loss and total assets for each reportable segment. An entity discloses certain information on each reportable segment if the amounts (a) are included in the measure of segment profit or loss reviewed by the chief operating decision maker or (b) are otherwise regularly provided to the chief operating decision maker, even if not included in that measure of segment profit or loss.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 280<br> -SubTopic 10<br> -Section 50<br> -Paragraph 30<br> -URI http://asc.fasb.org/extlink&amp;oid=68060357&amp;loc=d3e8906-108599<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 280<br> -SubTopic 10<br> -Section 50<br> -Paragraph 25<br> -URI http://asc.fasb.org/extlink&amp;oid=68060357&amp;loc=d3e8813-108599<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 280<br> -SubTopic 10<br> -Section 50<br> -Paragraph 21<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=68060357&amp;loc=d3e8721-108599<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=35741047&amp;loc=d3e13816-109267<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 280<br> -SubTopic 10<br> -Section 50<br> -Paragraph 22<br> -URI http://asc.fasb.org/extlink&amp;oid=68060357&amp;loc=d3e8736-108599<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6913227072">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Investments (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract', window );"><strong>Investments, Debt and Equity Securities [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesTextBlock', window );">Schedule of Investments</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 Investments held are summarized as follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="52%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31, 2017</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31, 2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b><font style="WHITE-SPACE: nowrap">Short-Term</font></b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b><font style="WHITE-SPACE: nowrap">Long-Term</font></b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b><font style="WHITE-SPACE: nowrap">Short-Term</font></b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b><font style="WHITE-SPACE: nowrap">Long-Term</font></b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Municipal debt securities</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">8,312</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">46,195</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">10,306</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">46,513</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Federal home loan securities</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,000</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">30,322</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">28,747</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Certificates of deposit</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">980</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4,165</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">980</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">3,715</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">10,292</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">80,682</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">11,286</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">78,975</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock', window );">Schedule of Contractual Maturities of Long-Term Investments</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 Contractual maturities of long-term investments are summarized as
 follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="74%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2017</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Due after one year through five years</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">78,561</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">70,005</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Due after five years through six years</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,121</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8,970</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">80,682</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">78,975</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
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 </div><span></span>
</td>
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<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_HeldToMaturitySecuritiesTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of all investments in certain debt and equity securities for which the entity has the positive intent and ability to hold until maturity.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 50<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=82897076&amp;loc=d3e27290-111563<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 50<br> -Paragraph 10<br> -URI http://asc.fasb.org/extlink&amp;oid=82897076&amp;loc=d3e27405-111563<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 50<br> -Paragraph 5<br> -URI http://asc.fasb.org/extlink&amp;oid=82897076&amp;loc=d3e27232-111563<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 320<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=75019621&amp;loc=d3e62586-112803<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 50<br> -Paragraph 7<br> -URI http://asc.fasb.org/extlink&amp;oid=82897076&amp;loc=d3e27337-111563<br><br>Reference 6: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 815<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -URI http://asc.fasb.org/extlink&amp;oid=6435544&amp;loc=d3e41834-113960<br><br>Reference 7: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 310<br> -SubTopic 10<br> -Section 50<br> -Paragraph 5<br> -URI http://asc.fasb.org/extlink&amp;oid=84173941&amp;loc=d3e5086-111524<br><br>Reference 8: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 320<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=75019621&amp;loc=d3e62557-112803<br></p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of maturities of an entity's investments as well as any other information pertinent to the investments.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6911175104">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accounts Receivable and Net Revenue (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ReceivablesAbstract', window );"><strong>Receivables [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock', window );">Schedule of Accounts Receivable, Net</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 Accounts receivable, net consists of the following (in
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 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
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 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom">&#xA0;</td>
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 Gross accounts receivable</p>
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 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,790,034</td>
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 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,719,642</td>
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 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Allowance for contractual adjustments and uncollectibles</p>
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 <td valign="bottom" align="right">(1,286,035</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
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 <td valign="bottom" align="right">(1,224,366</td>
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 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
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 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <td>&#xA0;</td>
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 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 &#xA0;</p>
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 <td valign="bottom" align="right">503,999</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
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 <td valign="bottom">$</td>
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 &#xA0;</p>
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 &#xA0;</p>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTableTextBlock', window );">Schedule of Net Revenue</a></td>
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 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 Net revenue consists of the following (in thousands):</p>
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 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom">&#xA0;</td>
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 Gross revenue</p>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">11,427,238</td>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">10,374,813</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">8,942,957</td>
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 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Contractual adjustments and uncollectibles</p>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(8,285,317</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(7,464,030</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(6,389,195</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
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 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Hospital contract administrative fees</p>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">316,391</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">272,376</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">226,234</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
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 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <td valign="top"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">3,458,312</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
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 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
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 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <td valign="bottom">&#xA0;</td>
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 &#xA0;</p>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
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<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ReceivablesAbstract</td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the various types of trade accounts and notes receivable and for each the gross carrying value, allowance, and net carrying value as of the balance sheet date. Presentation is categorized by current, noncurrent and unclassified receivables.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.3,4)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of patient service revenue (net of contractual allowances and discounts), by major payor source of revenue for health care organizations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 954<br> -SubTopic 605<br> -Section 55<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=68073389&amp;loc=SL9156489-173031<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 954<br> -SubTopic 605<br> -Section 50<br> -Paragraph 4<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=68052803&amp;loc=SL9156464-115641<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6769226928">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Property and Equipment (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
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 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
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 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
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 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
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 <td valign="top"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
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 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
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 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">(143,708</font></td>
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 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
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 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
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 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
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 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
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 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of physical assets used in the normal conduct of business and not intended for resale. Includes, but is not limited to, balances by class of assets, depreciation and depletion expense and method used, including composite depreciation, and accumulated deprecation.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(13))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
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<tr>
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 <td valign="bottom" width="7%"></td>
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 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Other intangible
 assets</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">39,414</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Current
 liabilities</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(5,674</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Other long-term
 liabilities</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(21,086</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">553,918</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
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 <td>&#xA0;</td>
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</tr>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the amounts recognized as of the acquisition date for each major class of assets acquired and liabilities assumed. May include but not limited to the following: (a) acquired receivables; (b) contingencies recognized at the acquisition date; and (c) the fair value of noncontrolling interests in the acquiree.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=84161108&amp;loc=d3e4845-128472<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6914887568">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Goodwill and Intangible Assets (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
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<td class="text">&#160;<span></span>
</td>
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<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock', window );">Summary of Intangible Assets, Net</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">Intangible
 assets, net, consist of the following (in thousands):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="64%"></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>December&#xA0;31,
 2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Gross<br />
 Carrying<br />
 Value</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Accumulated<br />
 Amortization</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Net<br />
 Carrying<br />
 Value</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Physician and hospital
 agreements</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">381,635</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(203,915</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">177,720</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Customer
 relationships</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">443,300</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(48,837</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">394,463</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Trade names</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">43,156</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(2,933</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">40,223</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Patented and other
 technology</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">38,590</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(11,068</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">27,522</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">906,681</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(266,753</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">639,928</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="64%"></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>December&#xA0;31,
 2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Gross<br />
 Carrying<br />
 Value</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Accumulated<br />
 Amortization</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Net<br />
 Carrying<br />
 Value</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Physician and hospital
 agreements</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">347,862</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(168,488</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">179,374</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Customer
 relationships</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">443,300</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(27,368</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">415,932</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Trade names</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">43,156</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(1,604</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">41,552</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Patented and other
 technology</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">37,503</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(5,832</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">31,671</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">871,821</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(203,292</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">668,529</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock', window );">Amortization Expenses for Existing Intangible Assets for the Next Five Years</a></td>
<td class="text"><div>
 <p style="margin-top:12px;margin-bottom:0px; text-indent:4%">
 <font style="font-family:Times New Roman" size="2">Amortization
 expense for existing intangible assets for the next five years is
 expected to be as follows (in thousands):</font></p>
 <p style="font-size:12px;margin-top:0px;margin-bottom:0px">
 &#xA0;</p>
 <table cellspacing="0" cellpadding="0" width="68%" border="0" style="BORDER-COLLAPSE:COLLAPSE" align="center">
 <tr>
 <td width="84%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr bgcolor="#CCEEFF" style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">2018</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">67,514</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">2019</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">62,669</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr bgcolor="#CCEEFF" style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">2020</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">56,636</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">2021</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">51,069</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr bgcolor="#CCEEFF" style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">2022</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">44,357</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 </table>
 </div><span></span>
</td>
</tr>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of amortization expense of assets, excluding financial assets, that lack physical substance, having a limited useful life.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of assets, excluding financial assets and goodwill, lacking physical substance with a finite life, by either major class or business segment.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16265-109275<br></p></div>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock', window );">Schedule of Accounts Payable and Accrued Expenses</a></td>
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 <font style="font-family:Times New Roman" size="2">Accounts payable
 and accrued expenses consist of the following (in
 thousands):</font></p>
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 <td valign="bottom" colspan="6" align="center" style="border-bottom:1px solid #000000"><font style="font-family:Times New Roman" size="1"><b>December&#xA0;31,</b></font></td>
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 <td valign="bottom"><font size="1">&#xA0;</font></td>
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 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
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 <td valign="top">
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 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">$</font></td>
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 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
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 <td valign="top">
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 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">220,635</font></td>
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 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">75,672</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">67,830</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
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 <td valign="top">
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 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">37,912</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">28,972</font></td>
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 <tr bgcolor="#CCEEFF" style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">Accrued contingent
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 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">6,259</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">6,566</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">Accrued interest</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">4,495</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">4,511</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr bgcolor="#CCEEFF" style="page-break-inside:avoid">
 <td valign="top">
 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">Other accrued
 expenses</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">53,618</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">50,950</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="font-size:1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:1px solid #000000">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="page-break-inside:avoid">
 <td valign="top"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">438,017</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="font-family:Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="font-family:Times New Roman" size="2">407,938</font></td>
 <td nowrap="nowrap" valign="bottom"><font style="font-family:Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="font-size:1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="border-top:3px double #000000">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
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</td>
</tr>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the (a) carrying value as of the balance sheet date of liabilities incurred (and for which invoices have typically been received) and payable to vendors for goods and services received that are used in an entity's business (accounts payable); (b) other payables; and (c) accrued liabilities. Examples include taxes, interest, rent and utilities. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer). An alternative caption includes accrued expenses.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6916251200">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accrued Professional Liabilities (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HealthCareOrganizationsAbstract', window );"><strong>Health Care Organizations [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock', window );">Schedule of Accrued Professional Liability</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The activity
 related to the Company&#x2019;s total accrued professional liability
 for the years ended December&#xA0;31, 2017, 2016 and 2015 is as
 follows (in thousands):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
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 <td width="63%"></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Years Ended
 December&#xA0;31,</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2015</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Balance at beginning of
 year</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">202,052</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">202,527</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">168,369</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Assumed liabilities through
 acquisition</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">20,716</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">&#x2014;&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">35,968</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Provision (adjustment) for
 losses related to:</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Current year</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">41,291</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">38,129</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">39,204</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Prior years</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">9,983</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(25,428</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(25,797</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Total provision for
 losses</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">51,274</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">12,701</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">13,407</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Claim payments related
 to:</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Current year</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(712</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(766</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(1,382</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Prior years</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(23,143</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(12,410</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(13,835</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Total payments</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(23,855</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(13,176</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(15,217</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Balance at end of
 year</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">250,187</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">202,052</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">202,527</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6769196384">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Line of Credit, Long-Term Debt and Capital Lease Obligations (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtDisclosureAbstract', window );"><strong>Debt Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfDebtTableTextBlock', window );">Schedule of Long-Term Debt</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The carrying
 value of the Company&#x2019;s long-term debt was $1.8&#xA0;billion
 and $1.7&#xA0;billion at December&#xA0;31, 2017 and 2016,
 respectively, and consisted of the following (in
 thousands):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="56%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>December&#xA0;31,
 2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Principal</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Unamortized<br />
 Debt<br />
 Issuance<br />
 Costs</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Total</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2023 Senior
 Notes</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">750,000</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(9,503</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">740,497</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Revolving line of
 credit</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,110,500</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(4,864</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,105,636</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Total</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,860,500</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(14,367</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,846,133</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="57%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>December&#xA0;31,
 2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Principal</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Unamortized<br />
 Debt<br />
 Issuance<br />
 Costs</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Total</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2023 Senior
 Notes</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">750,000</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(11,109</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">738,891</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Revolving line of
 credit</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">783,500</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(3,388</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">780,112</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Term loan</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">180,000</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(259</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">179,741</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,713,500</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(14,756</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,698,744</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Less: Current
 portion</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(20,000</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">&#x2014;&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(20,000</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Long-term
 portion</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,693,500</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(14,756</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,678,744</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_ScheduleOfCapitalLeaseObligationsTableTextBlock', window );">Schedule of Capital Lease Obligations</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The
 Company&#x2019;s capital lease obligations consist of the following
 (in thousands):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="75%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="6" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>December&#xA0;31,</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Capital lease
 obligations</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,826</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">3,550</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Less: Current
 portion</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(1,401</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(2,054</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Long-term
 portion</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">425</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,496</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock', window );">Schedule of Amounts Due Under Terms of Capital Lease Obligations</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The amounts due
 under the terms of the Company&#x2019;s capital lease obligations at
 December&#xA0;31, 2017 are as follows:</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="68%" align="center" border="0">
 <tr>
 <td width="86%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2018</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,401</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2019</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">238</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2020</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">113</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">2021</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">74</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 </table>
 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_ScheduleOfCapitalLeaseObligationsTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Schedule of capital lease obligations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtDisclosureAbstract">
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtDisclosureAbstract</td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ScheduleOfDebtTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of information pertaining to short-term and long-debt instruments or arrangements, including but not limited to identification of terms, features, collateral requirements and other information necessary to a fair presentation.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ScheduleOfDebtTableTextBlock</td>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of future minimum lease payments as of the date of the latest balance sheet presented, in aggregate and for each of the five years succeeding fiscal years, with separate deductions from the total for the amount representing executor costs, including any profit thereon, included in the minimum lease payments and for the amount of the imputed interest necessary to reduce the net minimum lease payments to present value.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84164817&amp;loc=d3e45280-112737<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6931898976">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Income Taxes (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxDisclosureAbstract', window );"><strong>Income Tax Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock', window );">Summary of Components of Income Tax Provision</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 The components of the income tax provision (benefit) are as follows
 (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="62%"></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2017</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2015</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Federal:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Current</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">130,053</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">166,758</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">168,596</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Deferred</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(63,038</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">15,596</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">12,866</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">67,015</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">182,354</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">181,462</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 State:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Current</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">20,070</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4,296</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">20,948</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Deferred</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,965</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,553</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,628</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">23,035</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6,849</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">22,576</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">90,050</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">189,203</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">204,038</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock', window );">Schedule of Differences Between Effective Rate and United States Federal Income Tax Statutory Rate</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 The differences between the effective rate and the United States
 federal income tax statutory rate are as follows:</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="75%"></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2017</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>2015</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Tax at statutory rate</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">35.00</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">35.00</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">35.00</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 State income tax, net of federal benefit</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">3.33</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2.94</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2.97</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 <font style="WHITE-SPACE: nowrap">Non-deductible</font>
 expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.49</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.43</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.34</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Change in accrual estimates relating to uncertain tax positions</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.02</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(2.11</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(0.43</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Change in valuation allowance</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.48</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.29</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Other, net</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.16</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.06</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(0.41</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Change in tax law</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17.06</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income tax provision</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">21.94</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">36.80</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">37.76</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock', window );">Significant Components of Deferred Income Tax Assets and Liabilities</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">All of the
 Company&#x2019;s deferred tax assets and liabilities are classified
 as long-term. The significant components of deferred income tax
 assets and liabilities are as follows (in thousands):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="69%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="6" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>December&#xA0;31,</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Allowance for uncollectible
 accounts</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">80,056</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">103,525</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Reserves and
 accruals</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">45,454</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">62,212</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Stock-based
 compensation</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">7,975</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">13,726</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Net operating loss
 carryforward</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">28,569</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">49,156</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Property and
 equipment</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">685</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,621</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Other</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">970</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,610</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Deferred tax assets before
 valuation allowance</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">163,709</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">231,850</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Less: Valuation
 allowance</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(2,615</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(4,014</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Deferred tax assets, net of
 valuation allowance</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">161,094</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">227,836</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Gross deferred tax
 liabilities:</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Amortization</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(258,618</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(380,594</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Accrual to cash
 adjustment</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(31,290</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(53,771</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Other</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(4,150</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(1,023</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 5em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Total deferred tax
 liabilities</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(294,058</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(435,388</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 5em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Net deferred tax
 liability</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(132,964</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(207,552</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SummaryOfIncomeTaxContingenciesTextBlock', window );">Schedule of Activity Related to Gross Unrecognized Tax Benefits</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The following
 table summarizes the activity related to the Company&#x2019;s
 liability for uncertain tax positions for the years ended
 December&#xA0;31, 2017, 2016 and 2015 (in thousands):</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="66%"></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="10" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Years Ended
 December&#xA0;31,</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2017</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2016</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>2015</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Balance at beginning of
 year</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">9,469</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">18,447</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">17,165</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Increases related to prior
 year tax positions</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">2,284</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">301</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">467</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Decreases related to prior
 year tax positions</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(143</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(3,927</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(1,168</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Increases related to
 current year tax positions</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,430</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">2,258</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">3,675</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Settlements</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">&#x2014;&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(5,644</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">&#x2014;&#xA0;&#xA0;</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Decreases related to lapse
 of statutes of limitation</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(2,068</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(1,966</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(1,692</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Balance at end of
 year</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">10,972</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">9,469</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">18,447</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the components of income tax expense attributable to continuing operations for each year presented including, but not limited to: current tax expense (benefit), deferred tax expense (benefit), investment tax credits, government grants, the benefits of operating loss carryforwards, tax expense that results from allocating certain tax benefits either directly to contributed capital or to reduce goodwill or other noncurrent intangible assets of an acquired entity, adjustments of a deferred tax liability or asset for enacted changes in tax laws or rates or a change in the tax status of the entity, and adjustments of the beginning-of-the-year balances of a valuation allowance because of a change in circumstances that causes a change in judgment about the realizability of the related deferred tax asset in future years.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br></p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32537-109319<br></p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the reconciliation using percentage or dollar amounts of the reported amount of income tax expense attributable to continuing operations for the year to the amount of income tax expense that would result from applying domestic federal statutory tax rates to pretax income from continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br></p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure for tax positions taken in the tax returns filed or to be filed for which it is more likely than not that the tax position will not be sustained upon examination by taxing authorities and other income tax contingencies. Includes, but is not limited to, interest and penalties, reconciliation of unrecognized tax benefits, unrecognized tax benefits that would affect the effective tax rate, tax years that remain subject to examination by tax jurisdictions, and information about positions for which it is reasonably possible that amounts unrecognized will significantly change within 12 months.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15<br> -Subparagraph (d)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32718-109319<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 19<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32840-109319<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6779660160">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Common and Common Equivalent Shares (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerShareAbstract', window );"><strong>Earnings Per Share [Abstract]</strong></a></td>
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 <p style="margin-top:6px;margin-bottom:0px; text-indent:4%">
 <font style="font-family:Times New Roman" size="2">The calculation
 of shares used in the basic and diluted net income per share
 calculation for the years ended December&#xA0;31, 2017, 2016 and
 2015 is as follows (in thousands):</font></p>
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 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
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 <p style="margin-left:1.00em; text-indent:-1.00em"><font style="font-family:Times New Roman" size="2">Antidilutive securities not
 included in the diluted net income per common share
 calculation</font></p>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the weighted average number of shares used in calculating basic net earnings per share (or unit) and diluted earnings per share (or unit).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3550-109257<br></p></div>
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<DOCUMENT>
<TYPE>XML
<SEQUENCE>55
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<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6913142000">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Stock Incentive Plans and Stock Purchase Plans (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract', window );"><strong>Disclosure of Compensation Related Costs, Share-based Payments [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock', window );">Schedule of Restricted Stock and Deferred Stock Awards</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 12px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The activity
 related to the Company&#x2019;s restricted stock and deferred stock
 awards and the corresponding weighted average grant-date fair
 values for the year ended December&#xA0;31, 2017 are as
 follows:</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="68%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Number
 of</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>Shares</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Weighted<br />
 Average&#xA0;Fair<br />
 Value</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2"><font style="WHITE-SPACE: nowrap">Non-vested</font> shares at January&#xA0;1,
 2017</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">946,329</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">66.98</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Awarded</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">637,529</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">54.22</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Forfeited</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(91,730</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">64.82</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Vested</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(451,094</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">65.00</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2"><font style="WHITE-SPACE: nowrap">Non-vested</font> shares at December&#xA0;31,
 2017</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1,041,034</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">60.21</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 </table>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock', window );">Schedule of Activity and Certain Other Information Related to Stock Option Awards</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px; TEXT-INDENT: 4%">
 <font style="FONT-FAMILY: Times New Roman" size="2">The activity
 and certain other information related to the Company&#x2019;s
 outstanding stock option awards for the year ended
 December&#xA0;31, 2017 are as follows:</font></p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 12px; MARGIN-TOP: 0px">
 &#xA0;</p>
 <table style="BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="51%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Number&#xA0;of</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>Stock&#xA0;
 Options</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Weighted</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>Average</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>Exercise</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>Price</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Weighted<br />
 Average<br />
 Remaining<br />
 Contractual<br />
 Term</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>(in
 years)</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td style="BORDER-BOTTOM: #000000 1px solid" valign="bottom" colspan="2" align="center"><font style="FONT-FAMILY: Times New Roman" size="1"><b>Aggregate<br />
 Intrinsic</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>Value</b></font><br />
 <font style="FONT-FAMILY: Times New Roman" size="1"><b>(in&#xA0;millions)</b></font></td>
 <td valign="bottom"><font size="1">&#xA0;</font></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Outstanding at
 January&#xA0;1, 2017</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">410,286</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">28.33</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-LEFT: 3em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Exercised</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">(163,944</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">)&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">29.57</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">5.5</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 1px solid">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-LEFT: 1em; TEXT-INDENT: -1em"><font style="FONT-FAMILY: Times New Roman" size="2">Outstanding and exercisable
 at December&#xA0;31, 2017</font></p>
 </td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">246,342</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">27.51</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">1.5</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 <td valign="bottom"><font size="1">&#xA0;&#xA0;</font></td>
 <td valign="bottom"><font style="FONT-FAMILY: Times New Roman" size="2">$</font></td>
 <td valign="bottom" align="right"><font style="FONT-FAMILY: Times New Roman" size="2">6.4</font></td>
 <td valign="bottom" nowrap="nowrap"><font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="BORDER-TOP: #000000 3px double">&#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 </div><span></span>
</td>
</tr>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract</td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the number and weighted-average grant date fair value for restricted stock units that were outstanding at the beginning and end of the year, and the number of restricted stock units that were granted, vested, or forfeited during the year.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure for stock option plans. Includes, but is not limited to, outstanding awards at beginning and end of year, grants, exercises, forfeitures, and weighted-average grant date fair value.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (d)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (e)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6769151280">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Commitments and Contingencies (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
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<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock', window );">Schedule of Future Minimum Lease Payments under Non-Cancelable Operating Leases</a></td>
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 2018</p>
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 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">34,337</td>
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 2019</p>
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 2020</p>
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 2021</p>
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 2022</p>
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 Thereafter</p>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of future minimum payments required in the aggregate and for each of the five succeeding fiscal years for operating leases having initial or remaining noncancelable lease terms in excess of one year and the total minimum rentals to be received in the future under noncancelable subleases as of the balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6659030368">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Selected Quarterly Financial Information (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
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<tr><th class="th"><div>Dec. 31, 2017</div></th></tr>
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 <td valign="bottom">&#xA0;</td>
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 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="14" align="center"><b>2017 Quarters</b></td>
 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom">&#xA0;</td>
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 Net revenue</p>
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 <td valign="bottom">&#xA0;&#xA0;</td>
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 &#xA0;</p>
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 &#xA0;</p>
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 &#xA0;</p>
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 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
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 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
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 Practice salaries and benefits</p>
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 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
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 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
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 Practice supplies and other operating expenses</p>
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 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom">&#xA0;</td>
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 General and administrative expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">103,765</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">103,015</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">101,430</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">108,895</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Depreciation and amortization</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,614</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,735</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,116</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26,414</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total operating expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">729,560</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">721,040</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">742,519</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">785,117</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income from operations</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">106,037</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">121,904</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">126,432</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">125,703</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Investment and other income</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">576</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">365</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">235</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,777</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Interest expense</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17,752</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(18,535</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(18,428</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(19,844</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Equity (losses) in earnings of unconsolidated affiliate</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">797</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">689</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(240</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(294</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total <font style="WHITE-SPACE: nowrap">non-operating</font>
 expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(16,379</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17,481</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(18,433</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17,361</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income before income taxes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">89,658</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">104,423</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">107,999</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">108,342</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income tax (provision) benefit</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(34,967</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(40,725</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(42,119</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">27,761</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income attributable to MEDNAX, Inc.</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">54,691</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">63,698</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">65,880</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">136,103</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Per common and common equivalent share data (1):</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income attributable to MEDNAX, Inc.:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Basic</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.59</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.69</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.71</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1.47</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Diluted</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.59</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.69</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.71</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1.46</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Weighted average common shares:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Basic</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,360</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,181</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,589</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,756</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Diluted</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,143</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,812</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,881</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,159</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; MARGIN-TOP: 0pt">
 <font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="100%" border="0">
 <tr style="PAGE-BREAK-INSIDE: avoid">
 <td valign="top" width="4%" align="left">(1)</td>
 <td valign="top" align="left">Basic and diluted per share amounts
 are computed for each of the periods presented. Accordingly, the
 sum of the quarterly per share amounts may not agree with the full
 year amount.</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px">
 <font style="FONT-FAMILY: Times New Roman" size="2">&#xA0;</font></p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; BORDER-COLLAPSE: collapse" cellspacing="0" cellpadding="0" width="100%" align="center" border="0">
 <tr>
 <td width="64%"></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="14" align="center"><b>2016 Quarters</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>First</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>Second</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>Third</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="2" align="center"><b>Fourth</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net revenue</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">752,624</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">771,759</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">828,006</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">830,770</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Operating expenses:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Practice salaries and benefits</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">491,811</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">484,625</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">521,832</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">532,952</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Practice supplies and other operating expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">27,046</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26,992</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">31,641</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">32,737</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 General and administrative expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">89,950</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,116</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,457</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">97,049</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Depreciation and amortization</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">19,584</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">20,241</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">24,185</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,254</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total operating expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">628,391</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">623,974</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">671,115</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">687,992</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income from operations</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">124,233</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">147,785</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">156,891</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">142,778</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Investment and other income</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">618</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">410</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">221</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">770</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Interest expense</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(14,463</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(15,058</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17,215</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(16,356</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Equity in earnings of unconsolidated affiliate</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">794</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">789</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">796</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">806</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total <font style="WHITE-SPACE: nowrap">non-operating</font>
 expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(13,051</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(13,859</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(16,198</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(14,780</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income before income taxes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">111,182</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">133,926</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">140,693</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">127,998</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income tax provision</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(43,411</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(51,601</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(44,272</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(49,919</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">67,771</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">82,325</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">96,421</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">78,079</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net loss attributable to noncontrolling interests</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">128</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">102</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">88</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income attributable to MEDNAX, Inc.</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">67,899</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">82,427</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">96,509</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">78,079</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Per common and common equivalent share data (2):</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income attributable to MEDNAX, Inc.:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Basic</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.74</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.89</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1.04</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom">&#xA0;</td>
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 <td valign="bottom">&#xA0;</td>
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 &#xA0;</p>
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 &#xA0;</p>
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 <td valign="top" width="4%" align="left">(2)</td>
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 year amount.</td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of quarterly financial data. Includes, but is not limited to, financial information for fiscal quarters, cumulative effect of a change in accounting principle and earnings per share data.</p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6780468480">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Summary of Significant Accounting Policies - Additional Information (Detail) - USD ($)<br> $ in Millions</strong></div></th>
<th class="th" colspan="1">3 Months Ended</th>
<th class="th" colspan="2">12 Months Ended</th>
<th class="th" colspan="1"></th>
</tr>
<tr>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 08, 2015</div></th>
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<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SaleOfMinorityInterestPercentage', window );">Sale of minority interest percentage</a></td>
<td class="nump">75.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_CashAndCashEquivalentsMaturityDescription', window );">Cash and cash equivalents maturity description</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">90<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_BusinessCombinationContingentConsiderationArrangementsTimePeriod', window );">Additional amounts to be paid in cash or common stock based on achievement of performance measures within period, maximum years</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">5 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_MoneyMarketFundsAtFairValue', window );">Money market funds fair value</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 9.2<span></span>
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<td class="nump">$ 12.4<span></span>
</td>
<td class="text">&#160;<span></span>
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</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CashSurrenderValueFairValueDisclosure', window );">Cash surrender fair value of life insurance</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">15.6<span></span>
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<td class="nump">15.8<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized', window );">Contingent consideration liabilities related to acquisitions</a></td>
<td class="text">&#160;<span></span>
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<td class="nump">$ 30.5<span></span>
</td>
<td class="nump">$ 17.3<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentInterestRateStatedPercentage', window );">Debt instrument interest rate</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">5.25%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis=md_UnnamedCorporateJointVentureMember', window );">Unnamed Corporate Joint Venture [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EquityMethodInvestmentOwnershipPercentage', window );">Equity method ownership percentage in joint venture</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">37.50%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_GovernmentContractsConcentrationRiskMember', window );">Government Contracts Concentration Risk [Member] | Accounts Receivable [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Percentage of net accounts receivable</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">17.00%<span></span>
</td>
<td class="nump">17.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_BuildingMember', window );">Buildings [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">30 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MaximumMember', window );">Maximum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_LongTermInvestmentsMaturityPeriod', window );">Long-term investments maturity period, in years</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">6 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_ShortTermInvestmentMaturityPeriod', window );">Short-Term investments maturity period, in years</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">1 year<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetUsefulLife', window );">Intangible assets finite lives</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">20 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MaximumMember', window );">Maximum [Member] | Medical Equipment [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">7 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MaximumMember', window );">Maximum [Member] | Computer Equipment [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">7 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MaximumMember', window );">Maximum [Member] | Software and Software Development Costs [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">7 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MaximumMember', window );">Maximum [Member] | Furniture [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">7 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MinimumMember', window );">Minimum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_LongTermInvestmentsMaturityPeriod', window );">Long-term investments maturity period, in years</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">1 year<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetUsefulLife', window );">Intangible assets finite lives</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">1 year<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MinimumMember', window );">Minimum [Member] | Medical Equipment [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">3 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MinimumMember', window );">Minimum [Member] | Computer Equipment [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">3 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MinimumMember', window );">Minimum [Member] | Software and Software Development Costs [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">3 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MinimumMember', window );">Minimum [Member] | Furniture [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">3 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_BusinessCombinationContingentConsiderationArrangementsTimePeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Business combination, contingent consideration arrangements, time period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_BusinessCombinationContingentConsiderationArrangementsTimePeriod</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_CashAndCashEquivalentsMaturityDescription">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Cash and cash equivalents maturity description.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_CashAndCashEquivalentsMaturityDescription</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_LongTermInvestmentsMaturityPeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Long term investments maturity period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_LongTermInvestmentsMaturityPeriod</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_MoneyMarketFundsAtFairValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Money market funds at fair value.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_MoneyMarketFundsAtFairValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_SaleOfMinorityInterestPercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Sale of minority interest percentage.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_SaleOfMinorityInterestPercentage</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_ShortTermInvestmentMaturityPeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Short term investment maturity period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_ShortTermInvestmentMaturityPeriod</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_SummaryOfSignificantAccountingPoliciesLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Summary of significant accounting policies.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_SummaryOfSignificantAccountingPoliciesLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount, measured at acquisition-date fair value, of all liabilities assumed that arise from contingencies and were recognized by the entity.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (d)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161108&amp;loc=d3e4845-128472<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CashSurrenderValueFairValueDisclosure">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Fair value portion of the amount that could be realized under a life insurance contract or contracts owned by the entity, commonly known as corporate-owned life insurance (COLI) or bank-owned life insurance (BOLI).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CashSurrenderValueFairValueDisclosure</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ConcentrationRiskPercentage1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>For an entity that discloses a concentration risk in relation to quantitative amount, which serves as the "benchmark" (or denominator) in the equation, this concept represents the concentration percentage derived from the division.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 18<br> -URI http://asc.fasb.org/extlink&amp;oid=84177426&amp;loc=d3e6351-108592<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 825<br> -SubTopic 10<br> -Section 50<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=77997519&amp;loc=d3e13531-108611<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=84177426&amp;loc=d3e6404-108592<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 825<br> -SubTopic 10<br> -Section 50<br> -Paragraph 21<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77997519&amp;loc=d3e13537-108611<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ConcentrationRiskPercentage1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentInterestRateStatedPercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Contractual interest rate for funds borrowed, under the debt agreement.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.22(a)(1))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentInterestRateStatedPercentage</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EquityMethodInvestmentOwnershipPercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The percentage of ownership of common stock or equity participation in the investee accounted for under the equity method of accounting.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 323<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -Subparagraph (a)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=66011266&amp;loc=d3e33918-111571<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EquityMethodInvestmentOwnershipPercentage</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FiniteLivedIntangibleAssetUsefulLife">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Useful life of finite-lived intangible assets, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetUsefulLife</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentUsefulLife">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Useful life of long lived, physical assets used in the normal conduct of business and not intended for resale, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days. Examples include, but not limited to, land, buildings, machinery and equipment, office equipment, furniture and fixtures, and computer equipment.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentUsefulLife</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis=md_UnnamedCorporateJointVentureMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis=md_UnnamedCorporateJointVentureMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_GovernmentContractsConcentrationRiskMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ConcentrationRiskByTypeAxis=us-gaap_GovernmentContractsConcentrationRiskMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ConcentrationRiskByBenchmarkAxis=us-gaap_AccountsReceivableMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ConcentrationRiskByBenchmarkAxis=us-gaap_AccountsReceivableMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_BuildingMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_BuildingMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Data Type:</strong></td>
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<tr>
<td><strong> Balance Type:</strong></td>
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<tr>
<td><strong> Period Type:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RangeAxis=us-gaap_MaximumMember</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_EquipmentMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Balance Type:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_ComputerEquipmentMember</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_SoftwareAndSoftwareDevelopmentCostsMember</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_FurnitureAndFixturesMember</td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
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<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RangeAxis=us-gaap_MinimumMember</td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6763713856">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Summary of Significant Accounting Policies - Schedule of Net Revenue by Service Line (Detail) - Product Concentration Risk [Member] - Sales Revenue, Services, Net [Member]<br></strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingInformationLineItems', window );"><strong>Segment Reporting Information [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Net revenue in percentage</a></td>
<td class="nump">100.00%<span></span>
</td>
<td class="nump">100.00%<span></span>
</td>
<td class="nump">100.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember', window );">Anesthesiology [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingInformationLineItems', window );"><strong>Segment Reporting Information [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Net revenue in percentage</a></td>
<td class="nump">38.00%<span></span>
</td>
<td class="nump">39.00%<span></span>
</td>
<td class="nump">37.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember', window );">Neonatology and Other Pediatric Subspecialties [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingInformationLineItems', window );"><strong>Segment Reporting Information [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Net revenue in percentage</a></td>
<td class="nump">37.00%<span></span>
</td>
<td class="nump">39.00%<span></span>
</td>
<td class="nump">44.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember', window );">Maternal-Fetal Medicine [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingInformationLineItems', window );"><strong>Segment Reporting Information [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Net revenue in percentage</a></td>
<td class="nump">8.00%<span></span>
</td>
<td class="nump">8.00%<span></span>
</td>
<td class="nump">9.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember', window );">Radiology And Teleradiology [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingInformationLineItems', window );"><strong>Segment Reporting Information [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Net revenue in percentage</a></td>
<td class="nump">8.00%<span></span>
</td>
<td class="nump">6.00%<span></span>
</td>
<td class="nump">4.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember', window );">Management Services [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingInformationLineItems', window );"><strong>Segment Reporting Information [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Net revenue in percentage</a></td>
<td class="nump">6.00%<span></span>
</td>
<td class="nump">5.00%<span></span>
</td>
<td class="nump">2.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember', window );">Pediatric Cardiology [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingInformationLineItems', window );"><strong>Segment Reporting Information [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Net revenue in percentage</a></td>
<td class="nump">3.00%<span></span>
</td>
<td class="nump">3.00%<span></span>
</td>
<td class="nump">4.00%<span></span>
</td>
</tr>
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<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ConcentrationRiskPercentage1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>For an entity that discloses a concentration risk in relation to quantitative amount, which serves as the "benchmark" (or denominator) in the equation, this concept represents the concentration percentage derived from the division.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 18<br> -URI http://asc.fasb.org/extlink&amp;oid=84177426&amp;loc=d3e6351-108592<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 825<br> -SubTopic 10<br> -Section 50<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=77997519&amp;loc=d3e13531-108611<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=84177426&amp;loc=d3e6404-108592<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 825<br> -SubTopic 10<br> -Section 50<br> -Paragraph 21<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77997519&amp;loc=d3e13537-108611<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ConcentrationRiskPercentage1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SegmentReportingInformationLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
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<tr>
<td><strong> Balance Type:</strong></td>
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<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ConcentrationRiskByBenchmarkAxis=us-gaap_SalesRevenueServicesNetMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ConcentrationRiskByBenchmarkAxis=us-gaap_SalesRevenueServicesNetMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
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</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProductOrServiceAxis=md_AnesthesiologyMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProductOrServiceAxis=md_AnesthesiologyMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Data Type:</strong></td>
<td>na</td>
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<td><strong> Balance Type:</strong></td>
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<tr>
<td><strong> Period Type:</strong></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProductOrServiceAxis=md_NeonatologyAndOtherPediatricSubspecialtiesMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProductOrServiceAxis=md_NeonatologyAndOtherPediatricSubspecialtiesMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
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<tr>
<td><strong> Period Type:</strong></td>
<td></td>
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</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProductOrServiceAxis=md_MaternalFetalMedicineMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProductOrServiceAxis=md_MaternalFetalMedicineMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
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<tr>
<td><strong> Period Type:</strong></td>
<td></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProductOrServiceAxis=md_RadiologyAndTeleradiologyMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProductOrServiceAxis=md_RadiologyAndTeleradiologyMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
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<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
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</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProductOrServiceAxis=md_ManagementServicesMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProductOrServiceAxis=md_ManagementServicesMember</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
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<td><strong> Data Type:</strong></td>
<td>na</td>
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<td><strong> Balance Type:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProductOrServiceAxis=md_PediatricCardiologyMember</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
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<td><strong> Data Type:</strong></td>
<td>na</td>
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<tr>
<td><strong> Balance Type:</strong></td>
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<head>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6779102496">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Investments - Schedule of Investments (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems', window );"><strong>Schedule of Held-to-maturity Securities [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesCurrent', window );">Short-Term</a></td>
<td class="nump">$ 10,292<span></span>
</td>
<td class="nump">$ 11,286<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesNoncurrent', window );">Long-Term</a></td>
<td class="nump">80,682<span></span>
</td>
<td class="nump">78,975<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InvestmentTypeAxis=us-gaap_USStatesAndPoliticalSubdivisionsMember', window );">Municipal Debt Securities [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems', window );"><strong>Schedule of Held-to-maturity Securities [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesCurrent', window );">Short-Term</a></td>
<td class="nump">8,312<span></span>
</td>
<td class="nump">10,306<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesNoncurrent', window );">Long-Term</a></td>
<td class="nump">46,195<span></span>
</td>
<td class="nump">46,513<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InvestmentTypeAxis=us-gaap_USGovernmentSponsoredEnterprisesDebtSecuritiesMember', window );">Federal Home Loan Securities [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems', window );"><strong>Schedule of Held-to-maturity Securities [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesCurrent', window );">Short-Term</a></td>
<td class="nump">1,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesNoncurrent', window );">Long-Term</a></td>
<td class="nump">30,322<span></span>
</td>
<td class="nump">28,747<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InvestmentTypeAxis=us-gaap_CertificatesOfDepositMember', window );">Certificates of Deposit [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems', window );"><strong>Schedule of Held-to-maturity Securities [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesCurrent', window );">Short-Term</a></td>
<td class="nump">980<span></span>
</td>
<td class="nump">980<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesNoncurrent', window );">Long-Term</a></td>
<td class="nump">$ 4,165<span></span>
</td>
<td class="nump">$ 3,715<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_HeldToMaturitySecuritiesCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after other than temporary impairment (OTTI) accretion, of investments in debt securities classified as held-to-maturity, expected to be converted to cash, sold or exchanged within one year or the normal operating cycle.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=82896770&amp;loc=d3e26626-111562<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 25<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=75030427&amp;loc=d3e22054-111558<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_HeldToMaturitySecuritiesCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_HeldToMaturitySecuritiesNoncurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after other than temporary impairment (OTTI) accretion, of investments in debt securities classified as held-to-maturity, not expected to be converted to cash, sold or exchanged within one year or the normal operating cycle, if longer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 25<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=75030427&amp;loc=d3e22054-111558<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=82896770&amp;loc=d3e26626-111562<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_HeldToMaturitySecuritiesNoncurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_InvestmentTypeAxis=us-gaap_USStatesAndPoliticalSubdivisionsMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_InvestmentTypeAxis=us-gaap_USStatesAndPoliticalSubdivisionsMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_InvestmentTypeAxis=us-gaap_USGovernmentSponsoredEnterprisesDebtSecuritiesMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_InvestmentTypeAxis=us-gaap_USGovernmentSponsoredEnterprisesDebtSecuritiesMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
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</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_InvestmentTypeAxis=us-gaap_CertificatesOfDepositMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_InvestmentTypeAxis=us-gaap_CertificatesOfDepositMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
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<tr>
<td><strong> Period Type:</strong></td>
<td></td>
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<head>
<title></title>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6632279984">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Investments - Schedule of Contractual Maturities of Long-Term Investments (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract', window );"><strong>Investments, Debt and Equity Securities [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount', window );">Due after one year through five years</a></td>
<td class="nump">$ 78,561<span></span>
</td>
<td class="nump">$ 70,005<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount', window );">Due after five years through six years</a></td>
<td class="nump">2,121<span></span>
</td>
<td class="nump">8,970<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesNoncurrent', window );">Total</a></td>
<td class="nump">$ 80,682<span></span>
</td>
<td class="nump">$ 78,975<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Carrying amount of debt securities accounted for as held-to-maturity, net of adjustments including, but not limited to, accretion, amortization, collection of cash, previous other-than-temporary impairments (OTTI) recognized, and fair value hedge accounting adjustments, maturing in the fifth through tenth fiscal year following the latest fiscal year.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 50<br> -Paragraph 5<br> -Subparagraph (f)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=82897076&amp;loc=d3e27232-111563<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 320<br> -Section 50<br> -Paragraph 3<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=75019621&amp;loc=d3e62586-112803<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Data Type:</strong></td>
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<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Carrying amount of debt securities accounted for as held-to-maturity, net of adjustments including, but not limited to, accretion, amortization, collection of cash, previous other-than-temporary impairments (OTTI) recognized, and fair value hedge accounting adjustments, maturing in the next fiscal year through the fifth fiscal year following the latest fiscal year.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 50<br> -Paragraph 5<br> -Subparagraph (f)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=82897076&amp;loc=d3e27232-111563<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 320<br> -Section 50<br> -Paragraph 3<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=75019621&amp;loc=d3e62586-112803<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount</td>
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<td>instant</td>
</tr>
</table></div>
</div></td></tr>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after other than temporary impairment (OTTI) accretion, of investments in debt securities classified as held-to-maturity, not expected to be converted to cash, sold or exchanged within one year or the normal operating cycle, if longer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 25<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=75030427&amp;loc=d3e22054-111558<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=82896770&amp;loc=d3e26626-111562<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_HeldToMaturitySecuritiesNoncurrent</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Data Type:</strong></td>
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<td><strong> Balance Type:</strong></td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6920986368">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Accounts Receivable and Net Revenue - Schedule of Accounts Receivable, Net (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ReceivablesAbstract', window );"><strong>Receivables [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccountsReceivableGrossCurrent', window );">Gross accounts receivable</a></td>
<td class="nump">$ 1,790,034<span></span>
</td>
<td class="nump">$ 1,719,642<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent', window );">Allowance for contractual adjustments and uncollectibles</a></td>
<td class="num">(1,286,035)<span></span>
</td>
<td class="num">(1,224,366)<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccountsReceivableNetCurrent', window );">Accounts receivable, net</a></td>
<td class="nump">$ 503,999<span></span>
</td>
<td class="nump">$ 495,276<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AccountsReceivableGrossCurrent">
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amounts due from customers or clients, within one year of the balance sheet date (or the normal operating cycle, whichever is longer) for goods or services (including trade receivables) that have been delivered or sold in the normal course of business.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(3))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-03(5))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879938&amp;loc=d3e572229-122910<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AccountsReceivableGrossCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<tr>
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<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AccountsReceivableNetCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount due from customers or clients, within one year of the balance sheet date (or the normal operating cycle, whichever is longer), for goods or services (including trade receivables) that have been delivered or sold in the normal course of business, reduced to the estimated net realizable fair value by an allowance established by the entity of the amount it deems uncertain of collection.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(3))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(4))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AccountsReceivableNetCurrent</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>A valuation allowance for trade and other receivables due to an Entity within one year (or the normal operating cycle, whichever is longer) that are expected to be uncollectible.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.4)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 310<br> -SubTopic 10<br> -Section 50<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=84173941&amp;loc=d3e5074-111524<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td>credit</td>
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<td>instant</td>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6765952512">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accounts Receivable and Net Revenue - Schedule of Net Revenue (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="8">3 Months Ended</th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Sep. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Sep. 30, 2016</div></th>
<th class="th"><div>Jun. 30, 2016</div></th>
<th class="th"><div>Mar. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ReceivablesAbstract', window );"><strong>Receivables [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_HealthOrganizationRevenueGross', window );">Gross revenue</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 11,427,238<span></span>
</td>
<td class="nump">$ 10,374,813<span></span>
</td>
<td class="nump">$ 8,942,957<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_ContractualAdjustmentsAndUncollectibles', window );">Contractual adjustments and uncollectibles</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(8,285,317)<span></span>
</td>
<td class="num">(7,464,030)<span></span>
</td>
<td class="num">(6,389,195)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_HospitalContractAdministrativeFees', window );">Hospital contract administrative fees</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">316,391<span></span>
</td>
<td class="nump">272,376<span></span>
</td>
<td class="nump">226,234<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HealthCareOrganizationRevenue', window );">Net revenue</a></td>
<td class="nump">$ 910,820<span></span>
</td>
<td class="nump">$ 868,951<span></span>
</td>
<td class="nump">$ 842,944<span></span>
</td>
<td class="nump">$ 835,597<span></span>
</td>
<td class="nump">$ 830,770<span></span>
</td>
<td class="nump">$ 828,006<span></span>
</td>
<td class="nump">$ 771,759<span></span>
</td>
<td class="nump">$ 752,624<span></span>
</td>
<td class="nump">$ 3,458,312<span></span>
</td>
<td class="nump">$ 3,183,159<span></span>
</td>
<td class="nump">$ 2,779,996<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_ContractualAdjustmentsAndUncollectibles">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Contractual adjustments and uncollectibles.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_ContractualAdjustmentsAndUncollectibles</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_HealthOrganizationRevenueGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Health organization revenue gross.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_HealthOrganizationRevenueGross</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_HospitalContractAdministrativeFees">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Hospital contract administrative fees.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_HospitalContractAdministrativeFees</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_HealthCareOrganizationRevenue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of revenues recognized by the entity from providing services to in-patients, outpatients, residents in facilities owned or operated by the entity, from insurance premiums, or from goods provided or services performed.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03.1)<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_HealthCareOrganizationRevenue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ReceivablesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ReceivablesAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
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</div>
</body>
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</TEXT>
</DOCUMENT>
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<head>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6766715408">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accounts Receivable and Net Revenue - Additional Information (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="8">3 Months Ended</th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Sep. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Sep. 30, 2016</div></th>
<th class="th"><div>Jun. 30, 2016</div></th>
<th class="th"><div>Mar. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ReceivablesAbstract', window );"><strong>Receivables [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccountsReceivableNetCurrent', window );">Accounts receivable, net</a></td>
<td class="nump">$ 503,999<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 495,276<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 503,999<span></span>
</td>
<td class="nump">$ 495,276<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HealthCareOrganizationRevenue', window );">Net patient service revenue</a></td>
<td class="nump">$ 910,820<span></span>
</td>
<td class="nump">$ 868,951<span></span>
</td>
<td class="nump">$ 842,944<span></span>
</td>
<td class="nump">$ 835,597<span></span>
</td>
<td class="nump">$ 830,770<span></span>
</td>
<td class="nump">$ 828,006<span></span>
</td>
<td class="nump">$ 771,759<span></span>
</td>
<td class="nump">$ 752,624<span></span>
</td>
<td class="nump">$ 3,458,312<span></span>
</td>
<td class="nump">$ 3,183,159<span></span>
</td>
<td class="nump">$ 2,779,996<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AccountsReceivableNetCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount due from customers or clients, within one year of the balance sheet date (or the normal operating cycle, whichever is longer), for goods or services (including trade receivables) that have been delivered or sold in the normal course of business, reduced to the estimated net realizable fair value by an allowance established by the entity of the amount it deems uncertain of collection.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(3))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(4))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AccountsReceivableNetCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_HealthCareOrganizationRevenue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of revenues recognized by the entity from providing services to in-patients, outpatients, residents in facilities owned or operated by the entity, from insurance premiums, or from goods provided or services performed.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03.1)<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_HealthCareOrganizationRevenue</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<td><strong> Balance Type:</strong></td>
<td>credit</td>
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<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ReceivablesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ReceivablesAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
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<body>
<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6932553488">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Property Plant and Equipment - Schedule of Property and Equipment (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentAbstract', window );"><strong>Property, Plant and Equipment [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BuildingsAndImprovementsGross', window );">Building</a></td>
<td class="nump">$ 33,024<span></span>
</td>
<td class="nump">$ 26,572<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_Land', window );">Land</a></td>
<td class="nump">6,683<span></span>
</td>
<td class="nump">6,683<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FixturesAndEquipmentGross', window );">Equipment and other</a></td>
<td class="nump">253,453<span></span>
</td>
<td class="nump">213,521<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentGross', window );">Property and equipment, gross</a></td>
<td class="nump">293,160<span></span>
</td>
<td class="nump">246,776<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment', window );">Accumulated depreciation</a></td>
<td class="num">(169,624)<span></span>
</td>
<td class="num">(143,708)<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentNet', window );">Property and equipment, net</a></td>
<td class="nump">$ 123,536<span></span>
</td>
<td class="nump">$ 103,068<span></span>
</td>
</tr>
</table>
<div style="display: none;">
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of accumulated depreciation, depletion and amortization for physical assets used in the normal conduct of business to produce goods and services.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.14)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BuildingsAndImprovementsGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before accumulated depreciation of building structures held for productive use including addition, improvement, or renovation to the structure, including, but not limited to, interior masonry, interior flooring, electrical, and plumbing.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 4<br> -Subparagraph (f)<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6812-107765<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BuildingsAndImprovementsGross</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FixturesAndEquipmentGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before accumulated depreciation of fixtures and equipment. Includes, but is not limited to, machinery, equipment, and engines.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FixturesAndEquipmentGross</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_Land">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before accumulated depletion of real estate held for productive use, excluding land held for sale.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 4<br> -Subparagraph (e)<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6812-107765<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.13)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_Land</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentAbstract</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td>xbrli:stringItemType</td>
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<td><strong> Balance Type:</strong></td>
<td>na</td>
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<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before accumulated depreciation, depletion and amortization of physical assets used in the normal conduct of business and not intended for resale. Examples include, but are not limited to, land, buildings, machinery and equipment, office equipment, and furniture and fixtures.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.13)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentGross</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after accumulated depreciation, depletion and amortization of physical assets used in the normal conduct of business to produce goods and services and not intended for resale. Examples include, but are not limited to, land, buildings, machinery and equipment, office equipment, and furniture and fixtures.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(13))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(14))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-03(a)(8))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879938&amp;loc=d3e572229-122910<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentNet</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<td><strong> Period Type:</strong></td>
<td>instant</td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6766134384">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Property and Equipment - Additional Information (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentLineItems', window );"><strong>Property, Plant and Equipment [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentGross', window );">Medical and other equipment held under capital leases</a></td>
<td class="nump">$ 293,160<span></span>
</td>
<td class="nump">$ 246,776<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment', window );">Accumulated depreciation of property and equipment held under capital leases</a></td>
<td class="nump">169,624<span></span>
</td>
<td class="nump">143,708<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_Depreciation', window );">Recorded depreciation expense</a></td>
<td class="nump">33,900<span></span>
</td>
<td class="nump">29,000<span></span>
</td>
<td class="nump">$ 22,200<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentByTypeAxis=md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember', window );">Medical and Other Equipment Held under Capital Lease [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentLineItems', window );"><strong>Property, Plant and Equipment [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentGross', window );">Medical and other equipment held under capital leases</a></td>
<td class="nump">6,100<span></span>
</td>
<td class="nump">6,200<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment', window );">Accumulated depreciation of property and equipment held under capital leases</a></td>
<td class="nump">$ 4,600<span></span>
</td>
<td class="nump">$ 4,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
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<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of accumulated depreciation, depletion and amortization for physical assets used in the normal conduct of business to produce goods and services.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.14)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_Depreciation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of expense recognized in the current period that reflects the allocation of the cost of tangible assets over the assets' useful lives. Includes production and non-production related depreciation.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_Depreciation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before accumulated depreciation, depletion and amortization of physical assets used in the normal conduct of business and not intended for resale. Examples include, but are not limited to, land, buildings, machinery and equipment, office equipment, and furniture and fixtures.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.13)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentGross</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentByTypeAxis=md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentByTypeAxis=md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
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<tr>
<td><strong> Period Type:</strong></td>
<td></td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6778234912">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Business Acquisitions - Additional Information (Detail)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="1">3 Months Ended</th>
<th class="th" colspan="2">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th">
<div>Dec. 31, 2017 </div>
<div>USD ($) </div>
<div>Company </div>
<div>shares</div>
</th>
<th class="th">
<div>Dec. 31, 2016 </div>
<div>USD ($) </div>
<div>Company </div>
<div>Acquisition</div>
</th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionLineItems', window );"><strong>Business Acquisition [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NumberOfPhysicianGroupPracticesAcquired', window );">Number of physician group practices acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">10<span></span>
</td>
<td class="nump">13<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NumberOfNeonatologyPracticesAcquired', window );">Number of neonatology practices acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1<span></span>
</td>
<td class="nump">1<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NumberOfMaternalfetalMedicinePracticesAcquired', window );">Number of maternal-fetal medicine practices acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">2<span></span>
</td>
<td class="nump">1<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NumberOfPediatricSubspecialtyPracticesAcquired', window );">Number of other pediatric subspecialty practices acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">2<span></span>
</td>
<td class="nump">2<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NumberOfPediatricMultiSpecialtyPracticesAcquired', window );">Number of pediatric multi-specialty practice acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NumberOfRadiologyPracticesAcquired', window );">Number of radiology practices acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">4<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationConsiderationTransferred1', window );">Total business acquisition consideration, net of cash acquired</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 554,000<span></span>
</td>
<td class="nump">$ 759,600<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PaymentsToAcquireBusinessesGross', window );">Cash payments to acquire businesses</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">531,700<span></span>
</td>
<td class="nump">756,100<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionEquityInterestIssuedOrIssuableValueAssigned', window );">Payments to acquire business by issue of common stock</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 2,700<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued', window );">Number of shares of common stock issued | shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">69,014<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationContingentConsiderationLiability', window );">Contingent consideration liability</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 18,600<span></span>
</td>
<td class="nump">$ 3,500<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_PurchaseConsiderationLiability', window );">Purchase consideration liability</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 1,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_BusinessCombinationDispositionOrAssignmentRestrictionPeriod', window );">Contractual restriction period on disposition or assignment of common stock</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">3 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrent', window );">Assets held for sale, current</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 23,500<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrentOther', window );">Assets held for sale, other noncurrent assets</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 22,500<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationContingentConsiderationArrangementsDescription', window );">Business combination contingent consideration arrangements description</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">The contingent consideration of $18.6 million recorded during the year ended December 31, 2017 is related to an agreement to pay an additional cash amount based on the achievement of certain performance measures for the period through June 1, 2019.<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RestrictedCashNoncurrent', window );">Restricted cash</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 20,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PaymentsForPreviousAcquisition', window );">Contingent consideration payments related to prior-period acquisitions</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">6,200<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NumberOfBusinessesAcquired', window );">Number of business acquired | Acquisition</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">15<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CashAcquiredFromAcquisition', window );">Cash acquired from acquisition</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 15,000<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NumberOfThirdpartyReceivablesCompaniesAcquired', window );">Number of third-party receivables companies acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NumberOfAnesthesiologyPracticesAcquired', window );">Number of anesthesiology practices acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">8<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NumberOfPediatricCardiologyPracticesAcquired', window );">Number of pediatric cardiology practices acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NumberOfPatientEngagementSoftwareCompanyAcquired', window );">Number of patient engagement software company acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SaleOfMinorityInterestPercentage', window );">Sale of minority interest percentage</a></td>
<td class="nump">75.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_DeconsolidationPercentage', window );">Deconsolidation percentage</a></td>
<td class="nump">100.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionAxis=md_PriorPeriodAcquisitionsMember', window );">Prior-Period Acquisitions [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionLineItems', window );"><strong>Business Acquisition [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedDeferredTaxLiabilitiesNoncurrent', window );">Increase in deferred tax liabilities</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">500<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_GoodwillPurchaseAccountingAdjustments', window );">Increase in goodwill resulting from finalization of tax acquisition accounting</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">500<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ContingentConsiderationByTypeAxis=md_ContingentConsiderationMember', window );">Contingent Consideration [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionLineItems', window );"><strong>Business Acquisition [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationContingentConsiderationArrangementsRangeOfOutcomesValueLow', window );">Range of the undiscounted amount under contingent consideration agreement, low</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">0<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationContingentConsiderationArrangementsRangeOfOutcomesValueHigh', window );">Range of the undiscounted amount under contingent consideration agreement, high</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">20,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RestrictedCashNoncurrent', window );">Restricted cash</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 20,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MinimumMember', window );">Minimum [Member] | Contingent Consideration [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionLineItems', window );"><strong>Business Acquisition [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FairValueInputsDiscountRate', window );">Assumed discount rates for acquisition-date fair value</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">4.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MaximumMember', window );">Maximum [Member] | Contingent Consideration [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionLineItems', window );"><strong>Business Acquisition [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FairValueInputsDiscountRate', window );">Assumed discount rates for acquisition-date fair value</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">4.75%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_BusinessCombinationDispositionOrAssignmentRestrictionPeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Business combination disposition or assignment restriction period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_BusinessCombinationDispositionOrAssignmentRestrictionPeriod</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_DeconsolidationPercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Deconsolidation percentage.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_DeconsolidationPercentage</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfAnesthesiologyPracticesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of anesthesiology practices acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfAnesthesiologyPracticesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfMaternalfetalMedicinePracticesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of maternal-fetal medicine practices acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfMaternalfetalMedicinePracticesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfNeonatologyPracticesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of neonatology practices acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfNeonatologyPracticesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfPatientEngagementSoftwareCompanyAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of patient engagement software company acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfPatientEngagementSoftwareCompanyAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfPediatricCardiologyPracticesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of pediatric cardiology practices acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfPediatricCardiologyPracticesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfPediatricMultiSpecialtyPracticesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of pediatric multi-specialty practices acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfPediatricMultiSpecialtyPracticesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfPediatricSubspecialtyPracticesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of other pediatric subspecialty practices acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfPediatricSubspecialtyPracticesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfPhysicianGroupPracticesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of physician group practices acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfPhysicianGroupPracticesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfRadiologyPracticesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of radiology practices acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfRadiologyPracticesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfThirdpartyReceivablesCompaniesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of third-party receivables companies acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfThirdpartyReceivablesCompaniesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_PurchaseConsiderationLiability">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Purchase consideration liability.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_PurchaseConsiderationLiability</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_SaleOfMinorityInterestPercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Sale of minority interest percentage.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_SaleOfMinorityInterestPercentage</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of assets held-for-sale that are not part of a disposal group, expected to be sold within a year or the normal operating cycle, if longer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section 15<br> -Paragraph 4<br> -Subparagraph (b)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=77912953&amp;loc=d3e400-110220<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrentOther">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of other assets held-for-sale that are not part of a disposal group, expected to be sold within a year or the normal operating cycle, if longer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section 15<br> -Paragraph 4<br> -Subparagraph (b)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=77912953&amp;loc=d3e400-110220<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AssetsHeldForSaleNotPartOfDisposalGroupCurrentOther</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessAcquisitionEquityInterestIssuedOrIssuableValueAssigned">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Value of equity interests (such as common shares, preferred shares, or partnership interest) issued or issuable to acquire the entity.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)(4)<br> -URI http://asc.fasb.org/extlink&amp;oid=35744584&amp;loc=d3e6927-128479<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessAcquisitionEquityInterestIssuedOrIssuableValueAssigned</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of shares of equity interests issued or issuable to acquire entity.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)(4)<br> -URI http://asc.fasb.org/extlink&amp;oid=35744584&amp;loc=d3e6927-128479<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessAcquisitionLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessAcquisitionLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessCombinationConsiderationTransferred1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of consideration transferred, consisting of acquisition-date fair value of assets transferred by the acquirer, liabilities incurred by the acquirer, and equity interest issued by the acquirer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 30<br> -Section 30<br> -Paragraph 7<br> -URI http://asc.fasb.org/extlink&amp;oid=6911251&amp;loc=d3e6578-128477<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=35744584&amp;loc=d3e6927-128479<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 30<br> -Section 30<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=6911251&amp;loc=d3e6613-128477<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationConsiderationTransferred1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessCombinationContingentConsiderationArrangementsDescription">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>For contingent consideration arrangements recognized in connection with a business combination, this element represents a description of such arrangements.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=35744584&amp;loc=d3e6927-128479<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationContingentConsiderationArrangementsDescription</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessCombinationContingentConsiderationArrangementsRangeOfOutcomesValueHigh">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>For contingent consideration arrangements recognized in connection with a business combination, this element represents an estimate of the high-end of the potential range (undiscounted) of the consideration which may be paid.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=35744584&amp;loc=d3e6927-128479<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationContingentConsiderationArrangementsRangeOfOutcomesValueHigh</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessCombinationContingentConsiderationArrangementsRangeOfOutcomesValueLow">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>For contingent consideration arrangements and indemnification assets recognized in connection with a business combination, this element represents an estimate of the low-end of the potential range (undiscounted) of the consideration which may be paid.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=35744584&amp;loc=d3e6927-128479<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationContingentConsiderationArrangementsRangeOfOutcomesValueLow</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessCombinationContingentConsiderationLiability">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of liability recognized arising from contingent consideration in a business combination.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=35744584&amp;loc=d3e6927-128479<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 30<br> -Section 35<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=6911338&amp;loc=d3e6819-128478<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 30<br> -Section 25<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=6911189&amp;loc=d3e6408-128476<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationContingentConsiderationLiability</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedDeferredTaxLiabilitiesNoncurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of deferred tax liability attributable to taxable temporary difference assumed at the acquisition date that are classified as noncurrent.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161108&amp;loc=d3e4845-128472<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedDeferredTaxLiabilitiesNoncurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CashAcquiredFromAcquisition">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cash inflow associated with the acquisition of business during the period (for example, cash that was held by the acquired business).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 12<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3179-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CashAcquiredFromAcquisition</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
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<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FairValueInputsDiscountRate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Interest rate used to find the present value of an amount to be paid or received in the future as an input to measure fair value.  For example, but not limited to, weighted average cost of capital (WACC), cost of capital, cost of equity and cost of debt.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 820<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (bbb)<br> -URI http://asc.fasb.org/extlink&amp;oid=66048111&amp;loc=d3e19207-110258<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FairValueInputsDiscountRate</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
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</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_GoodwillPurchaseAccountingAdjustments">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase (decrease) from adjustments after acquisition date under purchase accounting of an asset representing the future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 10<br> -Section 25<br> -Paragraph 16<br> -URI http://asc.fasb.org/extlink&amp;oid=84229725&amp;loc=d3e961-128460<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (g)<br> -URI http://asc.fasb.org/extlink&amp;oid=35741047&amp;loc=d3e13816-109267<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_GoodwillPurchaseAccountingAdjustments</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
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</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NumberOfBusinessesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The number of businesses acquired by the entity during the period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NumberOfBusinessesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PaymentsForPreviousAcquisition">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Cash outflow representing an adjustment to the purchase price of a previous acquisition.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PaymentsForPreviousAcquisition</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PaymentsToAcquireBusinessesGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cash outflow associated with the acquisition of business during the period. The cash portion only of the acquisition price.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 13<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3213-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PaymentsToAcquireBusinessesGross</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
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<td><strong> Period Type:</strong></td>
<td>duration</td>
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</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_RestrictedCashNoncurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash restricted as to withdrawal or usage, classified as noncurrent. Cash includes, but is not limited to, currency on hand, demand deposits with banks or financial institutions, and other accounts with general characteristics of demand deposits.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=SL98516268-108586<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(17))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 4<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6812-107765<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3044-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RestrictedCashNoncurrent</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessAcquisitionAxis=md_PriorPeriodAcquisitionsMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessAcquisitionAxis=md_PriorPeriodAcquisitionsMember</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ContingentConsiderationByTypeAxis=md_ContingentConsiderationMember</td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_RangeAxis=us-gaap_MinimumMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RangeAxis=us-gaap_MinimumMember</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6780058352">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Business Acquisitions - Summary of Company's Preliminary Allocation of Purchase Price (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionLineItems', window );"><strong>Business Acquisition [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
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</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_Goodwill', window );">Goodwill</a></td>
<td class="nump">$ 4,283,963<span></span>
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<td class="nump">$ 3,845,157<span></span>
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</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionAxis=md_PhysicianGroupMember', window );">Physician Group [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionLineItems', window );"><strong>Business Acquisition [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets', window );">Current assets</a></td>
<td class="nump">43,550<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedPropertyPlantAndEquipment', window );">Property and equipment</a></td>
<td class="nump">5,281<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedOtherNoncurrentAssets', window );">Other noncurrent assets</a></td>
<td class="nump">52,611<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_Goodwill', window );">Goodwill</a></td>
<td class="nump">439,822<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles', window );">Other intangible assets</a></td>
<td class="nump">39,414<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentLiabilities', window );">Current liabilities</a></td>
<td class="num">(5,674)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther', window );">Other long-term liabilities</a></td>
<td class="num">(21,086)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredGoodwillAndLiabilitiesAssumedNet', window );">Total assets and liabilities</a></td>
<td class="nump">$ 553,918<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
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<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessAcquisitionLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessAcquisitionLineItems</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of assets that are expected to be realized or consumed within one year or the normal operating cycle, if longer, acquired at the acquisition date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161108&amp;loc=d3e4845-128472<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets</td>
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<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<td><strong> Balance Type:</strong></td>
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<td><strong> Period Type:</strong></td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of liabilities due within one year or within the normal operating cycle, if longer, assumed at the acquisition date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161108&amp;loc=d3e4845-128472<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentLiabilities</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of identifiable intangible assets recognized as of the acquisition date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 10<br> -Section 55<br> -Paragraph 37<br> -URI http://asc.fasb.org/extlink&amp;oid=84160947&amp;loc=d3e2207-128464<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161108&amp;loc=d3e4845-128472<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles</td>
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<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
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<td><strong> Balance Type:</strong></td>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of other liabilities due after one year or the normal operating cycle, if longer, assumed at the acquisition date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161108&amp;loc=d3e4845-128472<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
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<td><strong> Balance Type:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of other assets expected to be realized or consumed after one year or the normal operating cycle, if longer, acquired at the acquisition date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161108&amp;loc=d3e4845-128472<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedOtherNoncurrentAssets</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<td><strong> Period Type:</strong></td>
<td>instant</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of property, plant, and equipment recognized as of the acquisition date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161108&amp;loc=d3e4845-128472<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 10<br> -Section 55<br> -Paragraph 37<br> -URI http://asc.fasb.org/extlink&amp;oid=84160947&amp;loc=d3e2207-128464<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedPropertyPlantAndEquipment</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Data Type:</strong></td>
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<td><strong> Balance Type:</strong></td>
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<td><strong> Period Type:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount recognized for assets, including goodwill, in excess of (less than) the aggregate liabilities assumed.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161108&amp;loc=d3e4845-128472<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredGoodwillAndLiabilitiesAssumedNet</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_Goodwill">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=35741047&amp;loc=d3e13816-109267<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 20<br> -Section 45<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6388280&amp;loc=d3e13770-109266<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 20<br> -Section 45<br> -Paragraph 5<br> -URI http://asc.fasb.org/extlink&amp;oid=77989000&amp;loc=SL49117168-202975<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_Goodwill</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
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<td><strong> Name:</strong></td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6766270672">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Goodwill and Intangible Assets - Additional Information (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_GoodwillAndOtherIntangibleAssetsLineItems', window );"><strong>Goodwill And Other Intangible Assets [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
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</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_Goodwill', window );">Goodwill</a></td>
<td class="nump">$ 4,283,963<span></span>
</td>
<td class="nump">$ 3,845,157<span></span>
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<td class="text">&#160;<span></span>
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<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_GoodwillPeriodIncreaseDecrease', window );">Change in goodwill carrying amount</a></td>
<td class="nump">438,800<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount', window );">Goodwill deductible for tax purpose</a></td>
<td class="nump">159,500<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FinitelivedIntangibleAssetsAcquired1', window );">Intangible assets related to acquisitions</a></td>
<td class="nump">39,400<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AmortizationOfIntangibleAssets', window );">Amortization expense for intangible assets</a></td>
<td class="nump">$ 68,900<span></span>
</td>
<td class="nump">$ 60,300<span></span>
</td>
<td class="nump">$ 42,000<span></span>
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<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=md_PhysicianAndHospitalAgreementsMember', window );">Physician And Hospital Agreements [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_GoodwillAndOtherIntangibleAssetsLineItems', window );"><strong>Goodwill And Other Intangible Assets [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
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<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife', window );">Weighted average amortization period</a></td>
<td class="text">10 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_GoodwillAndOtherIntangibleAssetsLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Goodwill And Other Intangible Assets [Line Items]</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_GoodwillAndOtherIntangibleAssetsLineItems</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Weighted average amortization period of finite-lived intangible assets acquired either individually or as part of a group of assets, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16265-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AmortizationOfIntangibleAssets">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate expense charged against earnings to allocate the cost of intangible assets (nonphysical assets not used in production) in a systematic and rational manner to the periods expected to benefit from such assets. As a noncash expense, this element is added back to net income when calculating cash provided by or used in operations using the indirect method.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=6388964&amp;loc=d3e16225-109274<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AmortizationOfIntangibleAssets</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
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</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of goodwill arising from a business combination that is expected to be deductible for tax purposes.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (d)<br> -URI http://asc.fasb.org/extlink&amp;oid=35744584&amp;loc=d3e6927-128479<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FinitelivedIntangibleAssetsAcquired1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase in assets, excluding financial assets, lacking physical substance with a definite life, from an acquisition.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FinitelivedIntangibleAssetsAcquired1</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Balance Type:</strong></td>
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<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_Goodwill">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=35741047&amp;loc=d3e13816-109267<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 20<br> -Section 45<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6388280&amp;loc=d3e13770-109266<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 20<br> -Section 45<br> -Paragraph 5<br> -URI http://asc.fasb.org/extlink&amp;oid=77989000&amp;loc=SL49117168-202975<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_Goodwill</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_GoodwillPeriodIncreaseDecrease">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase (decrease) of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=35741047&amp;loc=d3e13816-109267<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_GoodwillPeriodIncreaseDecrease</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
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<td><strong> Balance Type:</strong></td>
<td>na</td>
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<tr>
<td><strong> Period Type:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=md_PhysicianAndHospitalAgreementsMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
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<td><strong> Balance Type:</strong></td>
<td></td>
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<tr>
<td><strong> Period Type:</strong></td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6766939792">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Goodwill and Intangible Assets - Summary of Intangible Assets, Net (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsLineItems', window );"><strong>Finite-Lived Intangible Assets [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsGross', window );">Gross Carrying Value</a></td>
<td class="nump">$ 906,681<span></span>
</td>
<td class="nump">$ 871,821<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization', window );">Accumulated Amortization</a></td>
<td class="num">(266,753)<span></span>
</td>
<td class="num">(203,292)<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsNet', window );">Net Carrying Value</a></td>
<td class="nump">639,928<span></span>
</td>
<td class="nump">668,529<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=md_PhysicianAndHospitalAgreementsMember', window );">Physician And Hospital Agreements [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsLineItems', window );"><strong>Finite-Lived Intangible Assets [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsGross', window );">Gross Carrying Value</a></td>
<td class="nump">381,635<span></span>
</td>
<td class="nump">347,862<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization', window );">Accumulated Amortization</a></td>
<td class="num">(203,915)<span></span>
</td>
<td class="num">(168,488)<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsNet', window );">Net Carrying Value</a></td>
<td class="nump">177,720<span></span>
</td>
<td class="nump">179,374<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=us-gaap_CustomerRelationshipsMember', window );">Customer Relationships [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsLineItems', window );"><strong>Finite-Lived Intangible Assets [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsGross', window );">Gross Carrying Value</a></td>
<td class="nump">443,300<span></span>
</td>
<td class="nump">443,300<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization', window );">Accumulated Amortization</a></td>
<td class="num">(48,837)<span></span>
</td>
<td class="num">(27,368)<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsNet', window );">Net Carrying Value</a></td>
<td class="nump">394,463<span></span>
</td>
<td class="nump">415,932<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=us-gaap_TradeNamesMember', window );">Trade Names [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsLineItems', window );"><strong>Finite-Lived Intangible Assets [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsGross', window );">Gross Carrying Value</a></td>
<td class="nump">43,156<span></span>
</td>
<td class="nump">43,156<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization', window );">Accumulated Amortization</a></td>
<td class="num">(2,933)<span></span>
</td>
<td class="num">(1,604)<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsNet', window );">Net Carrying Value</a></td>
<td class="nump">40,223<span></span>
</td>
<td class="nump">41,552<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=md_PatentedAndOtherTechnologyMember', window );">Patented and Other Technology [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsLineItems', window );"><strong>Finite-Lived Intangible Assets [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsGross', window );">Gross Carrying Value</a></td>
<td class="nump">38,590<span></span>
</td>
<td class="nump">37,503<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization', window );">Accumulated Amortization</a></td>
<td class="num">(11,068)<span></span>
</td>
<td class="num">(5,832)<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsNet', window );">Net Carrying Value</a></td>
<td class="nump">$ 27,522<span></span>
</td>
<td class="nump">$ 31,671<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Accumulated amount of amortization of assets, excluding financial assets and goodwill, lacking physical substance with a finite life.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
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</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FiniteLivedIntangibleAssetsGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before amortization of assets, excluding financial assets and goodwill, lacking physical substance with a finite life.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsGross</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Data Type:</strong></td>
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<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<td><strong> Period Type:</strong></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FiniteLivedIntangibleAssetsLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsLineItems</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
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<td><strong> Balance Type:</strong></td>
<td>na</td>
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<td><strong> Period Type:</strong></td>
<td>duration</td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FiniteLivedIntangibleAssetsNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after amortization of assets, excluding financial assets and goodwill, lacking physical substance with a finite life.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsNet</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<td><strong> Period Type:</strong></td>
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</table></div>
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<tr>
<td><strong> Name:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=us-gaap_TradeNamesMember</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
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<td><strong> Data Type:</strong></td>
<td>na</td>
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<td><strong> Balance Type:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=md_PatentedAndOtherTechnologyMember</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6758357520">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Goodwill and Intangible Assets - Amortization Expenses for Existing Intangible Assets for the Next Five Years (Detail)<br> $ in Thousands</strong></div></th>
<th class="th">
<div>Dec. 31, 2017 </div>
<div>USD ($)</div>
</th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract', window );"><strong>Goodwill and Intangible Assets Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths', window );">Amortization expense for existing other intangible assets, 2018</a></td>
<td class="nump">$ 67,514<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo', window );">Amortization expense for existing other intangible assets, 2019</a></td>
<td class="nump">62,669<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree', window );">Amortization expense for existing other intangible assets, 2020</a></td>
<td class="nump">56,636<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour', window );">Amortization expense for existing other intangible assets, 2021</a></td>
<td class="nump">51,069<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive', window );">Amortization expense for existing other intangible assets, 2022</a></td>
<td class="nump">$ 44,357<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of amortization expense for assets, excluding financial assets and goodwill, lacking physical substance with a finite life expected to be recognized during the next fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of amortization expense for assets, excluding financial assets and goodwill, lacking physical substance with a finite life expected to be recognized during the fifth fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Data Type:</strong></td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of amortization expense for assets, excluding financial assets and goodwill, lacking physical substance with a finite life expected to be recognized during the fourth fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour</td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of amortization expense for assets, excluding financial assets and goodwill, lacking physical substance with a finite life expected to be recognized during the third fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of amortization expense for assets, excluding financial assets and goodwill, lacking physical substance with a finite life expected to be recognized during the second fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<td><strong> Period Type:</strong></td>
<td>instant</td>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract</td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6928684832">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Accounts Payable and Accrued Expenses - Schedule of Accounts Payable and Accrued Expenses (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PayablesAndAccrualsAbstract', window );"><strong>Payables and Accruals [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccountsPayableCurrent', window );">Accounts payable</a></td>
<td class="nump">$ 34,632<span></span>
</td>
<td class="nump">$ 28,474<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccruedSalariesCurrent', window );">Accrued salaries and bonuses</a></td>
<td class="nump">225,429<span></span>
</td>
<td class="nump">220,635<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_AccruedPayrollTaxesAndBenefitsCurrent', window );">Accrued payroll taxes and benefits</a></td>
<td class="nump">75,672<span></span>
</td>
<td class="nump">67,830<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent', window );">Accrued professional liabilities</a></td>
<td class="nump">37,912<span></span>
</td>
<td class="nump">28,972<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_AccruedContingentConsiderationLiabilityCurrent', window );">Accrued contingent consideration</a></td>
<td class="nump">6,259<span></span>
</td>
<td class="nump">6,566<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InterestPayableCurrent', window );">Accrued interest</a></td>
<td class="nump">4,495<span></span>
</td>
<td class="nump">4,511<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OtherAccruedLiabilitiesCurrent', window );">Other accrued expenses</a></td>
<td class="nump">53,618<span></span>
</td>
<td class="nump">50,950<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent', window );">Accounts payable and accrued expenses, total</a></td>
<td class="nump">$ 438,017<span></span>
</td>
<td class="nump">$ 407,938<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_AccruedContingentConsiderationLiabilityCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Accrued contingent consideration liability current.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_AccruedContingentConsiderationLiabilityCurrent</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
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<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_AccruedPayrollTaxesAndBenefitsCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Accrued payroll taxes and benefits current.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_AccruedPayrollTaxesAndBenefitsCurrent</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
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<td><strong> Balance Type:</strong></td>
<td>credit</td>
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<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Sum of the carrying values as of the balance sheet date of obligations incurred through that date and due within one year (or the operating cycle, if longer), including liabilities incurred (and for which invoices have typically been received) and payable to vendors for goods and services received, taxes, interest, rent and utilities, accrued salaries and bonuses, payroll taxes and fringe benefits.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.19,20)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AccountsPayableCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Carrying value as of the balance sheet date of liabilities incurred (and for which invoices have typically been received) and payable to vendors for goods and services received that are used in an entity's business. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.19(a))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AccountsPayableCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
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</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AccruedSalariesCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Carrying value as of the balance sheet date of the obligations incurred through that date and payable for employees' services provided. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.20)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6911-107765<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6935-107765<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AccruedSalariesCurrent</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Data Type:</strong></td>
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</tr>
<tr>
<td><strong> Balance Type:</strong></td>
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<td><strong> Period Type:</strong></td>
<td>instant</td>
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</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_InterestPayableCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Carrying value as of the balance sheet date of [accrued] interest payable on all forms of debt, including trade payables, that has been incurred and is unpaid. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.20)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 9<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e7018-107765<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6935-107765<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_InterestPayableCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of the current portion of the accrued liability on an undiscounted basis for malpractice claims (including general and professional liability).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 450<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=82911808&amp;loc=d3e14326-108349<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OtherAccruedLiabilitiesCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of expenses incurred but not yet paid classified as other, due within one year or the normal operating cycle, if longer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 9<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e7018-107765<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6911-107765<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6935-107765<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.20)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OtherAccruedLiabilitiesCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PayablesAndAccrualsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PayablesAndAccrualsAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
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</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>73
<FILENAME>R55.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
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							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
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</head>
<body>
<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6932186896">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Accrued Professional Liabilities - Additional Information (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
<th class="th"><div>Dec. 31, 2014</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PayablesAndAccrualsAbstract', window );"><strong>Payables and Accruals [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyAccrualUndiscounted', window );">Total accrued professional liability</a></td>
<td class="nump">$ 250,187<span></span>
</td>
<td class="nump">$ 202,052<span></span>
</td>
<td class="nump">$ 202,527<span></span>
</td>
<td class="nump">$ 168,369<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SelfInsuranceReserveCurrent', window );">Accrued professional liability incurred but loss reserves not reported for claims</a></td>
<td class="nump">138,500<span></span>
</td>
<td class="nump">128,100<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_AccruedProfessionalLiability', window );">Accrued professional liability incurred and loss reserves reported for claims</a></td>
<td class="nump">111,700<span></span>
</td>
<td class="nump">74,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent', window );">Accrued professional liabilities</a></td>
<td class="nump">37,912<span></span>
</td>
<td class="nump">$ 28,972<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InsuranceSettlementsReceivable', window );">Insurance receivables</a></td>
<td class="nump">$ 18,900<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_AccruedProfessionalLiability">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Accrued professional liability.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_AccruedProfessionalLiability</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_InsuranceSettlementsReceivable">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount due in settlement of a claim for reimbursement from an insurance company when the Company has suffered a loss covered under an insurance policy.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_InsuranceSettlementsReceivable</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyAccrualUndiscounted">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of the accrued liability on an undiscounted basis for malpractice claims (including general and professional liability) at the end of the accounting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 450<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=82911808&amp;loc=d3e14326-108349<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_MalpracticeLossContingencyAccrualUndiscounted</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of the current portion of the accrued liability on an undiscounted basis for malpractice claims (including general and professional liability).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 450<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=82911808&amp;loc=d3e14326-108349<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PayablesAndAccrualsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PayablesAndAccrualsAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_SelfInsuranceReserveCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Carrying amount of accrued known and estimated losses incurred as of the balance sheet date for which no insurance coverage exists, and for which a claim has been made or is probable of being asserted, typically arising from workmen's compensation-type of incidents and personal injury to nonemployees from accidents on the entity's property that are expected to be paid within one year (or the normal operating cycle, if longer).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SelfInsuranceReserveCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>74
<FILENAME>R56.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6766279296">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accrued Professional Liabilities - Schedule of Accrued Professional Liability (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PayablesAndAccrualsAbstract', window );"><strong>Payables and Accruals [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyAccrualUndiscounted', window );">Balance at beginning of year</a></td>
<td class="nump">$ 202,052<span></span>
</td>
<td class="nump">$ 202,527<span></span>
</td>
<td class="nump">$ 168,369<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition', window );">Assumed liabilities through acquisition</a></td>
<td class="nump">20,716<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">35,968<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_ProvisionAdjustmentForLossesRelatedToCurrentYear', window );">Provision (adjustment) for losses related to Current year</a></td>
<td class="nump">41,291<span></span>
</td>
<td class="nump">38,129<span></span>
</td>
<td class="nump">39,204<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_ProvisionAdjustmentForLossesRelatedToPriorYear', window );">Provision (adjustment) for losses related to Prior years</a></td>
<td class="nump">9,983<span></span>
</td>
<td class="num">(25,428)<span></span>
</td>
<td class="num">(25,797)<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_MalpracticeLossContingencyProvisionForLosses', window );">Total provision for losses</a></td>
<td class="nump">51,274<span></span>
</td>
<td class="nump">12,701<span></span>
</td>
<td class="nump">13,407<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod', window );">Claim payments related to Current year</a></td>
<td class="num">(712)<span></span>
</td>
<td class="num">(766)<span></span>
</td>
<td class="num">(1,382)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods', window );">Claim payments related to Prior years</a></td>
<td class="num">(23,143)<span></span>
</td>
<td class="num">(12,410)<span></span>
</td>
<td class="num">(13,835)<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyClaimsIncurredNet', window );">Total payments</a></td>
<td class="num">(23,855)<span></span>
</td>
<td class="num">(13,176)<span></span>
</td>
<td class="num">(15,217)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyAccrualUndiscounted', window );">Balance at end of year</a></td>
<td class="nump">$ 250,187<span></span>
</td>
<td class="nump">$ 202,052<span></span>
</td>
<td class="nump">$ 202,527<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Accrued professional liabilities assumed through acquisition.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_MalpracticeLossContingencyProvisionForLosses">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Malpractice loss contingency provision for losses.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_MalpracticeLossContingencyProvisionForLosses</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_ProvisionAdjustmentForLossesRelatedToCurrentYear">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Provision (adjustment) for losses related to current year.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_ProvisionAdjustmentForLossesRelatedToCurrentYear</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_ProvisionAdjustmentForLossesRelatedToPriorYear">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Provision (adjustment) for losses related to prior year.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_ProvisionAdjustmentForLossesRelatedToPriorYear</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyAccrualUndiscounted">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of the accrued liability on an undiscounted basis for malpractice claims (including general and professional liability) at the end of the accounting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 450<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=82911808&amp;loc=d3e14326-108349<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_MalpracticeLossContingencyAccrualUndiscounted</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of loss recognized for asserted and unasserted malpractice claims.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 954<br> -SubTopic 450<br> -Section 30<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=68049836&amp;loc=d3e5870-115623<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 450<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=82911808&amp;loc=d3e14326-108349<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase in asserted and unasserted malpractice claims that were originally recognized in a prior period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 450<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=82911808&amp;loc=d3e14326-108349<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 954<br> -SubTopic 450<br> -Section 30<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=68049836&amp;loc=d3e5870-115623<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyClaimsIncurredNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of costs associated with malpractice claims and insurance premiums incurred during an accounting period, less insurance recoveries and returns of previously paid premiums.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 954<br> -SubTopic 720<br> -Section 25<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=68060100&amp;loc=d3e8578-115644<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 450<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=82911808&amp;loc=d3e14326-108349<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 954<br> -SubTopic 450<br> -Section 30<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=68049836&amp;loc=d3e5870-115623<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_MalpracticeLossContingencyClaimsIncurredNet</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PayablesAndAccrualsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PayablesAndAccrualsAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6780693216">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Line of Credit, Long-Term Debt and Capital Lease Obligations - Additional Information (Detail) - USD ($)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
<th class="th" colspan="1"></th>
<th class="th" colspan="1"></th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 08, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LineOfCreditFacilityExpirationDate1', window );">Line of Credit facility, maturity date</a></td>
<td class="text">Oct. 31,  2022<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LongTermDebt', window );">Long term debt</a></td>
<td class="nump">$ 1,846,133,000<span></span>
</td>
<td class="nump">$ 1,698,744,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LettersOfCreditOutstandingAmount', window );">Letters of credit outstanding amount</a></td>
<td class="nump">200,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity', window );">Line of Credit facility, available balance</a></td>
<td class="nump">$ 889,300,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MinimumMember', window );">Minimum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LineOfCreditFacilityCommitmentFeePercentage', window );">Commitment fee percentage</a></td>
<td class="nump">0.15%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MaximumMember', window );">Maximum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LineOfCreditFacilityCommitmentFeePercentage', window );">Commitment fee percentage</a></td>
<td class="nump">0.30%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentAxis=md_AlternateBaseRateMember', window );">Alternate Base Rate [Member] | Federal Funds Rate [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
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<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentDescriptionOfVariableRateBasis', window );">Debt instrument, interest rate</a></td>
<td class="text">Federal Funds Rate plus 1/2 of 1.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentAxis=md_AlternateBaseRateMember', window );">Alternate Base Rate [Member] | LIBOR [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentDescriptionOfVariableRateBasis', window );">Debt instrument, interest rate</a></td>
<td class="text">LIBOR for an interest period of one month plus 1.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentBasisSpreadOnVariableRate1', window );">Debt instrument, variable interest rate</a></td>
<td class="nump">1.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentAxis=md_ApplicableMarginRateMember', window );">Applicable Margin Rate [Member] | LIBOR [Member] | Minimum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentBasisSpreadOnVariableRate1', window );">Debt instrument, variable interest rate</a></td>
<td class="nump">0.125%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentAxis=md_ApplicableMarginRateMember', window );">Applicable Margin Rate [Member] | LIBOR [Member] | Maximum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentBasisSpreadOnVariableRate1', window );">Debt instrument, variable interest rate</a></td>
<td class="nump">0.75%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_UnsecuredRevolvingCreditFacilityMember', window );">Unsecured Revolving Credit Facility [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity', window );">Line of Credit facility, borrowing capacity</a></td>
<td class="nump">$ 2,000,000,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=us-gaap_LetterOfCreditMember', window );">Letters of Credit [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity', window );">Line of Credit facility, borrowing capacity</a></td>
<td class="nump">$ 37,500,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentFaceAmount', window );">Aggregate principal amount of debt</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 750,000,000<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentInterestRateStatedPercentage', window );">Debt instrument interest rate</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">5.25%<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentMaturityDateDescription', window );">Debt instrument maturity date description</a></td>
<td class="text">Payable semi-annually in arrears on June 1 and December 1<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_DebtInstrumentMaturityYear', window );">Debt instrument, maturity year</a></td>
<td class="text">2023<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LongTermDebt', window );">Long term debt</a></td>
<td class="nump">$ 740,497,000<span></span>
</td>
<td class="nump">738,891,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NotesPayableFairValueDisclosure', window );">Estimated fair value of notes</a></td>
<td class="nump">$ 763,100,000<span></span>
</td>
<td class="nump">$ 773,400,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member] | Change In Control [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">101.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member] | Redemption Before 2018 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">100.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member] | Redemption Before 2018 [Member] | Redeem up to 35% of Aggregate Principal Amount [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">35.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentage', window );">Redemption price percentage of aggregate principal amount redeemed</a></td>
<td class="nump">105.25%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member] | Redemption in 2018 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">103.938%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member] | Redemption in 2019[Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">102.625%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member] | Redemption in 2020 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">101.313%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member] | Redemption in 2021 and Thereafter [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">100.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_DebtInstrumentMaturityYear">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Debt instrument maturity year.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_DebtInstrumentMaturityYear</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:gYearItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentBasisSpreadOnVariableRate1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage points added to the reference rate to compute the variable rate on the debt instrument.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentBasisSpreadOnVariableRate1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentDescriptionOfVariableRateBasis">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The reference rate for the variable rate of the debt instrument, such as LIBOR or the US Treasury rate and the maturity of the reference rate used, such as three months or six months LIBOR.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentDescriptionOfVariableRateBasis</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentFaceAmount">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Face (par) amount of debt instrument at time of issuance.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 835<br> -SubTopic 30<br> -Section 55<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=64930739&amp;loc=d3e28878-108400<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 835<br> -SubTopic 30<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=64930785&amp;loc=d3e28551-108399<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentFaceAmount</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentInterestRateStatedPercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Contractual interest rate for funds borrowed, under the debt agreement.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.22(a)(1))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentInterestRateStatedPercentage</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentMaturityDateDescription">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Description of the maturity date of the debt instrument including whether the debt matures serially and, if so, a brief description of the serial maturities.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.22(a)(2))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentMaturityDateDescription</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentRedemptionPricePercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage price of original principal amount of debt at which debt can be redeemed by the issuer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 470<br> -Section 50<br> -Paragraph 3<br> -Subparagraph e<br> -URI http://asc.fasb.org/extlink&amp;oid=75038535&amp;loc=d3e64711-112823<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPricePercentage</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of principal amount of debt redeemed.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LettersOfCreditOutstandingAmount">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The total amount of the contingent obligation under letters of credit outstanding as of the reporting date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LettersOfCreditOutstandingAmount</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LineOfCreditFacilityCommitmentFeePercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The fee, expressed as a percentage of the line of credit facility, for the line of credit facility regardless of whether the facility has been used.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LineOfCreditFacilityCommitmentFeePercentage</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LineOfCreditFacilityExpirationDate1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Date the credit facility terminates, in CCYY-MM-DD format.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.19(b),22(b))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LineOfCreditFacilityExpirationDate1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:dateItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Maximum borrowing capacity under the credit facility without consideration of any current restrictions on the amount that could be borrowed or the amounts currently outstanding under the facility.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.19(b),22(b))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of borrowing capacity currently available under the credit facility (current borrowing capacity less the amount of borrowings outstanding).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.19(b),22(b))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LongTermDebt">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount, after unamortized (discount) premium and debt issuance costs, of long-term debt. Includes, but not limited to, notes payable, bonds payable, debentures, mortgage loans and commercial paper. Excludes capital lease obligations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-03(a)(16))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879938&amp;loc=d3e572229-122910<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-03(16))<br> -URI http://asc.fasb.org/extlink&amp;oid=6876686&amp;loc=d3e534808-122878<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(22))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LongTermDebt</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NotesPayableFairValueDisclosure">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Fair value portion of notes payable.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.19,20,22)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NotesPayableFairValueDisclosure</td>
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<tr>
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<td><strong> Period Type:</strong></td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RangeAxis=us-gaap_MaximumMember</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentAxis=md_AlternateBaseRateMember</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_VariableRateAxis=us-gaap_FederalFundsEffectiveSwapRateMember</td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_VariableRateAxis=us-gaap_LondonInterbankOfferedRateLIBORMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_VariableRateAxis=us-gaap_LondonInterbankOfferedRateLIBORMember</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentAxis=md_ApplicableMarginRateMember</td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=md_UnsecuredRevolvingCreditFacilityMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=us-gaap_LetterOfCreditMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CreditFacilityAxis=us-gaap_LetterOfCreditMember</td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OtherOwnershipInterestsByNameAxis=md_ChangeInControlMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OtherOwnershipInterestsByNameAxis=md_ChangeInControlMember</td>
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</table></div>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentRedemptionPeriodAxis=md_DebtInstrumentRedemptionPeriodBeforeTwoThousandEighteenMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPeriodAxis=md_DebtInstrumentRedemptionPeriodBeforeTwoThousandEighteenMember</td>
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<td><strong> Data Type:</strong></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StatementScenarioAxis=md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StatementScenarioAxis=md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember</td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentRedemptionPeriodAxis=us-gaap_DebtInstrumentRedemptionPeriodOneMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPeriodAxis=us-gaap_DebtInstrumentRedemptionPeriodOneMember</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPeriodAxis=us-gaap_DebtInstrumentRedemptionPeriodTwoMember</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentRedemptionPeriodAxis=us-gaap_DebtInstrumentRedemptionPeriodThreeMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPeriodAxis=us-gaap_DebtInstrumentRedemptionPeriodThreeMember</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPeriodAxis=md_DebtInstrumentRedemptionPeriodFourAndThereafterMember</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<DOCUMENT>
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<SEQUENCE>76
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<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6763414000">
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<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Line of Credit, Long-Term Debt and Capital Lease Obligations - Schedule of Long-Term Debt (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
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<td class="nump">$ 1,860,500<span></span>
</td>
<td class="nump">$ 1,713,500<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_DebtInstrumentCarryingAmountCurrent', window );">Less: Current portion, principal</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(20,000)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_DebtInstrumentCarryingAmountNonCurrent', window );">Debt instrument principal long-term portion</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1,693,500<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnamortizedDebtIssuanceExpense', window );">Unamortized debt issuance cost</a></td>
<td class="num">(14,367)<span></span>
</td>
<td class="num">(14,756)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_UnamortizedDebtIssuanceExpenseCurrent', window );">Less: Current portion, unamortized debt issuance costs</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">0<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_UnamortizedDebtIssuanceExpenseNoncurrent', window );">Long-term portion, principal, unamortized debt issuance costs</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(14,756)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LongTermDebt', window );">Long term debt</a></td>
<td class="nump">1,846,133<span></span>
</td>
<td class="nump">1,698,744<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LongTermDebtCurrent', window );">Less: Current portion</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(20,000)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LongTermDebtNoncurrent', window );">Long-term portion</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1,678,744<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentCarryingAmount', window );">Debt instrument principal amount</a></td>
<td class="nump">750,000<span></span>
</td>
<td class="nump">750,000<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnamortizedDebtIssuanceExpense', window );">Unamortized debt issuance cost</a></td>
<td class="num">(9,503)<span></span>
</td>
<td class="num">(11,109)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LongTermDebt', window );">Long term debt</a></td>
<td class="nump">740,497<span></span>
</td>
<td class="nump">738,891<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=us-gaap_RevolvingCreditFacilityMember', window );">Revolving Credit Facility [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentCarryingAmount', window );">Debt instrument principal amount</a></td>
<td class="nump">1,110,500<span></span>
</td>
<td class="nump">783,500<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnamortizedDebtIssuanceExpense', window );">Unamortized debt issuance cost</a></td>
<td class="num">(4,864)<span></span>
</td>
<td class="num">(3,388)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LongTermDebt', window );">Long term debt</a></td>
<td class="nump">$ 1,105,636<span></span>
</td>
<td class="nump">780,112<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_TermLoanCreditFacilityMember', window );">Term Loan Credit Facility [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentCarryingAmount', window );">Debt instrument principal amount</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">180,000<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnamortizedDebtIssuanceExpense', window );">Unamortized debt issuance cost</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(259)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LongTermDebt', window );">Long term debt</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 179,741<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_DebtInstrumentCarryingAmountCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Debt instrument carrying amount current.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_DebtInstrumentCarryingAmountCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_DebtInstrumentCarryingAmountNonCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Debt instrument carrying amount non current.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_DebtInstrumentCarryingAmountNonCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_UnamortizedDebtIssuanceExpenseCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Unamortized Debt Issuance Expense Current</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_UnamortizedDebtIssuanceExpenseCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_UnamortizedDebtIssuanceExpenseNoncurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Unamortized Debt Issuance Expense Noncurrent</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_UnamortizedDebtIssuanceExpenseNoncurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentCarryingAmount">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount, before unamortized (discount) premium and debt issuance costs, of long-term debt. Includes, but is not limited to, notes payable, bonds payable, commercial loans, mortgage loans, convertible debt, subordinated debt and other types of debt.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(22))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-03(16))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879938&amp;loc=d3e572229-122910<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-03(16))<br> -URI http://asc.fasb.org/extlink&amp;oid=6876686&amp;loc=d3e534808-122878<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentCarryingAmount</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LongTermDebt">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount, after unamortized (discount) premium and debt issuance costs, of long-term debt. Includes, but not limited to, notes payable, bonds payable, debentures, mortgage loans and commercial paper. Excludes capital lease obligations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-03(a)(16))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879938&amp;loc=d3e572229-122910<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-03(16))<br> -URI http://asc.fasb.org/extlink&amp;oid=6876686&amp;loc=d3e534808-122878<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(22))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LongTermDebt</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LongTermDebtCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount, after unamortized (discount) premium and debt issuance costs, of long-term debt, classified as current. Includes, but not limited to, notes payable, bonds payable, debentures, mortgage loans and commercial paper. Excludes capital lease obligations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.19,20)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LongTermDebtCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LongTermDebtNoncurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after unamortized (discount) premium and debt issuance costs of long-term debt classified as noncurrent and excluding amounts to be repaid within one year or the normal operating cycle, if longer. Includes, but not limited to, notes payable, bonds payable, debentures, mortgage loans and commercial paper. Excludes capital lease obligations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.22)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LongTermDebtNoncurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_UnamortizedDebtIssuanceExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The remaining balance of debt issuance expenses that were capitalized and are being amortized against income over the lives of the respective bond issues. This does not include the amounts capitalized as part of the cost of the utility plant or asset.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.17)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnamortizedDebtIssuanceExpense</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=us-gaap_RevolvingCreditFacilityMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CreditFacilityAxis=us-gaap_RevolvingCreditFacilityMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=md_TermLoanCreditFacilityMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CreditFacilityAxis=md_TermLoanCreditFacilityMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
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</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>77
<FILENAME>R59.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
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</head>
<body>
<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6769133888">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Line of Credit, Long-Term Debt and Capital Lease Obligations - Schedule of Capital Lease Obligations (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtDisclosureAbstract', window );"><strong>Debt Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalLeaseObligations', window );">Capital lease obligations</a></td>
<td class="nump">$ 1,826<span></span>
</td>
<td class="nump">$ 3,550<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalLeaseObligationsCurrent', window );">Less: Current portion</a></td>
<td class="num">(1,401)<span></span>
</td>
<td class="num">(2,054)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalLeaseObligationsNoncurrent', window );">Long-term portion</a></td>
<td class="nump">$ 425<span></span>
</td>
<td class="nump">$ 1,496<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CapitalLeaseObligations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount equal to the present value (the principal) at the beginning of the lease term of minimum lease payments during the lease term (excluding that portion of the payments representing executory costs such as insurance, maintenance, and taxes to be paid by the lessor, together with any profit thereon) net of payments or other amounts applied to the principal through the balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84164817&amp;loc=d3e45280-112737<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(22))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-03(a)(16))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879938&amp;loc=d3e572229-122910<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CapitalLeaseObligations</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CapitalLeaseObligationsCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of capital lease obligation due within one year or the normal operating cycle, if longer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84164817&amp;loc=d3e45280-112737<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(19))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84164758&amp;loc=d3e45023-112735<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CapitalLeaseObligationsCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CapitalLeaseObligationsNoncurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount equal to the present value (the principal) at the beginning of the lease term of minimum lease payments during the lease term (excluding that portion of the payments representing executory costs such as insurance, maintenance, and taxes to be paid by the lessor, together with any profit thereon) net of payments or other amounts applied to the principal, through the balance sheet date and due to be paid more than one year (or one operating cycle, if longer) after the balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84164817&amp;loc=d3e45280-112737<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84164758&amp;loc=d3e45023-112735<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.22)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CapitalLeaseObligationsNoncurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>78
<FILENAME>R60.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
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							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
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</head>
<body>
<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6918358288">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Line of Credit, Long-Term Debt and Capital Lease Obligations - Schedule of Amounts Due Under Terms of Capital Lease Obligations (Detail)<br> $ in Thousands</strong></div></th>
<th class="th">
<div>Dec. 31, 2017 </div>
<div>USD ($)</div>
</th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtDisclosureAbstract', window );"><strong>Debt Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent', window );">2018</a></td>
<td class="nump">$ 1,401<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears', window );">2019</a></td>
<td class="nump">238<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears', window );">2020</a></td>
<td class="nump">113<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalLeasesFutureMinimumPaymentsDueInFourYears', window );">2021</a></td>
<td class="nump">$ 74<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of minimum lease payments for capital leases due in the next fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84164817&amp;loc=d3e45280-112737<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CapitalLeasesFutureMinimumPaymentsDueInFourYears">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of minimum lease payments for capital leases due in the fourth fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84164817&amp;loc=d3e45280-112737<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CapitalLeasesFutureMinimumPaymentsDueInFourYears</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of minimum lease payments for capital leases due in the third fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84164817&amp;loc=d3e45280-112737<br></p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of minimum lease payments for capital leases due in the second fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84164817&amp;loc=d3e45280-112737<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6766575680">
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<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Income Taxes - Summary of Components of Income Tax Provision (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="8">3 Months Ended</th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Sep. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Sep. 30, 2016</div></th>
<th class="th"><div>Jun. 30, 2016</div></th>
<th class="th"><div>Mar. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxDisclosureAbstract', window );"><strong>Income Tax Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
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<td class="text">&#160;<span></span>
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<td class="text">&#160;<span></span>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CurrentFederalTaxExpenseBenefit', window );">Federal, Current</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 130,053<span></span>
</td>
<td class="nump">$ 166,758<span></span>
</td>
<td class="nump">$ 168,596<span></span>
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<tr class="re">
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<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(63,038)<span></span>
</td>
<td class="nump">15,596<span></span>
</td>
<td class="nump">12,866<span></span>
</td>
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<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations', window );">Federal income tax provision, Total</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">67,015<span></span>
</td>
<td class="nump">182,354<span></span>
</td>
<td class="nump">181,462<span></span>
</td>
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<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CurrentStateAndLocalTaxExpenseBenefit', window );">State, Current</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">20,070<span></span>
</td>
<td class="nump">4,296<span></span>
</td>
<td class="nump">20,948<span></span>
</td>
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<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit', window );">State, Deferred</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">2,965<span></span>
</td>
<td class="nump">2,553<span></span>
</td>
<td class="nump">1,628<span></span>
</td>
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<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations', window );">State income tax provision, Total</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">23,035<span></span>
</td>
<td class="nump">6,849<span></span>
</td>
<td class="nump">22,576<span></span>
</td>
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<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxExpenseBenefit', window );">Income tax provision, Total</a></td>
<td class="num">$ (27,761)<span></span>
</td>
<td class="nump">$ 42,119<span></span>
</td>
<td class="nump">$ 40,725<span></span>
</td>
<td class="nump">$ 34,967<span></span>
</td>
<td class="nump">$ 49,919<span></span>
</td>
<td class="nump">$ 44,272<span></span>
</td>
<td class="nump">$ 51,601<span></span>
</td>
<td class="nump">$ 43,411<span></span>
</td>
<td class="nump">$ 90,050<span></span>
</td>
<td class="nump">$ 189,203<span></span>
</td>
<td class="nump">$ 204,038<span></span>
</td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of current federal tax expense (benefit) pertaining to income (loss) from continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.4-08(h))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB Topic 6.I.7)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br></p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of current state and local tax expense (benefit) pertaining to income (loss) from continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.4-08(h))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB Topic 6.I.7)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br></p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of deferred federal income tax expense (benefit) pertaining to income (loss) from continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB Topic 6.I.7)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.4-08(h))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br></p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of deferred state and local tax expense (benefit) pertaining to income (loss) from continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.4-08(h))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB Topic 6.I.7)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of current and deferred federal income tax expense (benefit) attributable to income (loss) from continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 10<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32672-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.4-08.(h)(1))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
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</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxDisclosureAbstract">
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxDisclosureAbstract</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Data Type:</strong></td>
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<td><strong> Balance Type:</strong></td>
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<td><strong> Period Type:</strong></td>
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</table></div>
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</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxExpenseBenefit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (a),(b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.4-08.(h))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxExpenseBenefit</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of state and local current and deferred income tax expense (benefit) attributable to continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.4-08.(h)(1))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB TOPIC 6.I.7)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (a)-(b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
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</table></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6780632848">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Income Taxes - Additional Information (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="8">3 Months Ended</th>
<th class="th" colspan="3">12 Months Ended</th>
<th class="th" colspan="1"></th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Sep. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Sep. 30, 2016</div></th>
<th class="th"><div>Jun. 30, 2016</div></th>
<th class="th"><div>Mar. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
<th class="th"><div>Dec. 31, 2014</div></th>
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<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncomeTaxLineItems', window );"><strong>Income Tax [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateContinuingOperations', window );">Effective tax rate</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">21.94%<span></span>
</td>
<td class="nump">36.80%<span></span>
</td>
<td class="nump">37.76%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability', window );">Income tax benefit resulting from the reduction of deferred tax liabilities</a></td>
<td class="num">$ (70,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="num">$ (70,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_EffectiveIncomeTaxRateContinuingOperationsExcludingChangeInTaxRate', window );">Effective tax rate excluding impact of income tax benefit</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">39.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate', window );">Effective income tax rate favorable impact of change in uncertain tax positions</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 10,600<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_EffectiveIncomeTaxRateContinuingOperationsExcludingImpactOfTaxSettlement', window );">Effective tax rate excluding impact of tax settlement</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">38.87%<span></span>
</td>
<td class="nump">37.76%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncreaseDecreaseInDeferredLiabilities', window );">Increase (decrease) in net deferred tax liability</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="num">$ (74,600)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet', window );">Adjustment to additional paid-in capital for excess tax benefits related to stock-based awards</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 4,200<span></span>
</td>
<td class="nump">$ 11,600<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncomeTaxExpenseForExcessTaxDeficiencies', window );">Income tax expense for excess tax deficiencies</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">200<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingLossCarryforwards', window );">Net operating loss carryforwards for federal and state tax</a></td>
<td class="nump">116,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 130,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">116,000<span></span>
</td>
<td class="nump">130,000<span></span>
</td>
<td class="nump">136,600<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefits', window );">Uncertain tax position liability</a></td>
<td class="nump">10,972<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">9,469<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">10,972<span></span>
</td>
<td class="nump">9,469<span></span>
</td>
<td class="nump">18,447<span></span>
</td>
<td class="nump">$ 17,165<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate', window );">Unrecognized tax benefits that would impact effective tax rate</a></td>
<td class="nump">10,700<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">10,700<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease', window );">Increase (decrease) in uncertain tax position</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1,500<span></span>
</td>
<td class="num">(9,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DecreaseInUnrecognizedTaxBenefitsIsReasonablyPossible', window );">Expected decrease in uncertain tax position in the next twelve months</a></td>
<td class="nump">1,100<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1,100<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxExpenseBenefit', window );">Income tax expense (benefit)</a></td>
<td class="num">(27,761)<span></span>
</td>
<td class="nump">$ 42,119<span></span>
</td>
<td class="nump">$ 40,725<span></span>
</td>
<td class="nump">$ 34,967<span></span>
</td>
<td class="nump">49,919<span></span>
</td>
<td class="nump">$ 44,272<span></span>
</td>
<td class="nump">$ 51,601<span></span>
</td>
<td class="nump">$ 43,411<span></span>
</td>
<td class="nump">90,050<span></span>
</td>
<td class="nump">189,203<span></span>
</td>
<td class="nump">204,038<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued', window );">Company's accrued liability for interest and penalties related to income tax liabilities</a></td>
<td class="nump">$ 1,200<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 1,400<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1,200<span></span>
</td>
<td class="nump">1,400<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis=md_InterestAndPenaltiesMember', window );">Interest and Penalties [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncomeTaxLineItems', window );"><strong>Income Tax [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxExpenseBenefit', window );">Income tax expense (benefit)</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="num">$ (200)<span></span>
</td>
<td class="num">$ (7,900)<span></span>
</td>
<td class="nump">$ 600<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_TaxPeriodAxis=us-gaap_EarliestTaxYearMember', window );">Earliest Tax Year [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncomeTaxLineItems', window );"><strong>Income Tax [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OpenTaxYear', window );">Federal and state income tax examinations</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">2013<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_TaxPeriodAxis=us-gaap_LatestTaxYearMember', window );">Latest Tax Year [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncomeTaxLineItems', window );"><strong>Income Tax [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OpenTaxYear', window );">Federal and state income tax examinations</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">2016<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MinimumMember', window );">Minimum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncomeTaxLineItems', window );"><strong>Income Tax [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NetOperatingLossCarryForwardsExpirationDate', window );">Expiration period of operating loss carryforwards</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">2019<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RangeAxis=us-gaap_MaximumMember', window );">Maximum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncomeTaxLineItems', window );"><strong>Income Tax [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NetOperatingLossCarryForwardsExpirationDate', window );">Expiration period of operating loss carryforwards</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">2037<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_EffectiveIncomeTaxRateContinuingOperationsExcludingChangeInTaxRate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Effective income tax rate continuing operations excluding change in tax rate.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_EffectiveIncomeTaxRateContinuingOperationsExcludingChangeInTaxRate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_EffectiveIncomeTaxRateContinuingOperationsExcludingImpactOfTaxSettlement">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Effective income tax rate continuing operations excluding impact of tax settlement.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_EffectiveIncomeTaxRateContinuingOperationsExcludingImpactOfTaxSettlement</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_IncomeTaxExpenseForExcessTaxDeficiencies">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Income tax expense for excess tax deficiencies.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_IncomeTaxExpenseForExcessTaxDeficiencies</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_IncomeTaxLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Income Tax [Line Items]</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_IncomeTaxLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NetOperatingLossCarryForwardsExpirationDate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Net operating loss carry forwards expiration date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NetOperatingLossCarryForwardsExpirationDate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:gYearItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Unrecognized tax benefits impact effective tax rate.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase (decrease) in additional paid in capital (APIC) resulting from a tax benefit (deficiency) associated with an share-based compensation plan other than an employee stock ownership plan (ESOP).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DecreaseInUnrecognizedTaxBenefitsIsReasonablyPossible">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of decrease reasonably possible in the next twelve months for the unrecognized tax benefit.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15<br> -Subparagraph (d)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32718-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DecreaseInUnrecognizedTaxBenefitsIsReasonablyPossible</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateContinuingOperations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.4-08.(h)(2))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateContinuingOperations</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of estimated penalties and interest accrued as of the balance sheet date arising from income tax examinations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32718-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxExpenseBenefit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (a),(b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.4-08.(h))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxExpenseBenefit</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of income tax expense (benefit) from continuing operations attributable to an adjustment of a deferred tax liability or asset for enacted changes in tax laws or rates or a change in the tax status of the entity.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (g)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncreaseDecreaseInDeferredLiabilities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Change during the period in carrying value for all deferred liabilities due within one year or operating cycle.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncreaseDecreaseInDeferredLiabilities</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OpenTaxYear">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tax year that remains open to examination under enacted tax laws, in CCYY format.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15<br> -Subparagraph (e)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32718-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OpenTaxYear</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:gYearItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLossCarryforwards">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of operating loss carryforward, before tax effects, available to reduce future taxable income under enacted tax laws.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32559-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLossCarryforwards</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_UnrecognizedTaxBenefits">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of unrecognized tax benefits.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefits</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase (decrease) in unrecognized tax benefits attributable to uncertain tax positions taken in tax returns.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The total amount of unrecognized tax benefits that, if recognized, would affect the effective tax rate.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis=md_InterestAndPenaltiesMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis=md_InterestAndPenaltiesMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_TaxPeriodAxis=us-gaap_EarliestTaxYearMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_TaxPeriodAxis=us-gaap_EarliestTaxYearMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_TaxPeriodAxis=us-gaap_LatestTaxYearMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_TaxPeriodAxis=us-gaap_LatestTaxYearMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_RangeAxis=us-gaap_MinimumMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RangeAxis=us-gaap_MinimumMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
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<tr>
<td><strong> Period Type:</strong></td>
<td></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_RangeAxis=us-gaap_MaximumMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RangeAxis=us-gaap_MaximumMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
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<td><strong> Balance Type:</strong></td>
<td></td>
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<tr>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6926197264">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Income Taxes - Schedule of Differences Between Effective Rate and United States Federal Income Tax Statutory Rate (Detail)<br></strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxDisclosureAbstract', window );"><strong>Income Tax Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate', window );">Tax at statutory rate</a></td>
<td class="nump">35.00%<span></span>
</td>
<td class="nump">35.00%<span></span>
</td>
<td class="nump">35.00%<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes', window );">State income tax, net of federal benefit</a></td>
<td class="nump">3.33%<span></span>
</td>
<td class="nump">2.94%<span></span>
</td>
<td class="nump">2.97%<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense', window );">Non-deductible expenses</a></td>
<td class="nump">0.49%<span></span>
</td>
<td class="nump">0.43%<span></span>
</td>
<td class="nump">0.34%<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments', window );">Change in accrual estimates relating to uncertain tax positions</a></td>
<td class="nump">0.02%<span></span>
</td>
<td class="num">(2.11%)<span></span>
</td>
<td class="num">(0.43%)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance', window );">Change in valuation allowance</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">0.48%<span></span>
</td>
<td class="nump">0.29%<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent', window );">Other, net</a></td>
<td class="nump">0.16%<span></span>
</td>
<td class="nump">0.06%<span></span>
</td>
<td class="num">(0.41%)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate', window );">Change in tax law</a></td>
<td class="num">(17.06%)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateContinuingOperations', window );">Income tax provision</a></td>
<td class="nump">21.94%<span></span>
</td>
<td class="nump">36.80%<span></span>
</td>
<td class="nump">37.76%<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateContinuingOperations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.4-08.(h)(2))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateContinuingOperations</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of domestic federal statutory tax rate applicable to pretax income (loss).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB TOPIC 6.I)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations attributable to changes in the valuation allowance for deferred tax assets.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB TOPIC 6.I)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
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</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations attributable to changes in the income tax rates.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB TOPIC 6.I)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations attributable to nondeductible expenses.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB TOPIC 6.I)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations attributable to other adjustments.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB TOPIC 6.I)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
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<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of the difference, between reported income tax expense (benefit) and the expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations, that is attributable to tax exempt income, equity in earnings (loss) of an unconsolidated subsidiary, minority interest income (expense), tax holiday, disposition of a business, disposition of an asset, repatriation of foreign earnings, repatriation of foreign earnings jobs creation act of 2004, change in enacted tax rate, prior year income taxes, change in deferred tax asset valuation allowance, and other adjustments.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations applicable to state and local income tax expense (benefit), net of federal tax expense (benefit).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB TOPIC 6.I)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxDisclosureAbstract</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
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<td><strong> Balance Type:</strong></td>
<td>na</td>
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<td><strong> Period Type:</strong></td>
<td>duration</td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6767732416">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Income Taxes - Significant Components of Deferred Income Tax Assets and Liabilities (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxDisclosureAbstract', window );"><strong>Income Tax Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts', window );">Allowance for uncollectible accounts</a></td>
<td class="nump">$ 80,056<span></span>
</td>
<td class="nump">$ 103,525<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves', window );">Reserves and accruals</a></td>
<td class="nump">45,454<span></span>
</td>
<td class="nump">62,212<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost', window );">Stock-based compensation</a></td>
<td class="nump">7,975<span></span>
</td>
<td class="nump">13,726<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsOperatingLossCarryforwards', window );">Net operating loss carryforward</a></td>
<td class="nump">28,569<span></span>
</td>
<td class="nump">49,156<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment', window );">Property and equipment</a></td>
<td class="nump">685<span></span>
</td>
<td class="nump">1,621<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsOther', window );">Other</a></td>
<td class="nump">970<span></span>
</td>
<td class="nump">1,610<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsGross', window );">Deferred tax assets before valuation allowance</a></td>
<td class="nump">163,709<span></span>
</td>
<td class="nump">231,850<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsValuationAllowance', window );">Less: Valuation allowance</a></td>
<td class="num">(2,615)<span></span>
</td>
<td class="num">(4,014)<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsNet', window );">Deferred tax assets, net of valuation allowance</a></td>
<td class="nump">161,094<span></span>
</td>
<td class="nump">227,836<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxLiabilitiesAbstract', window );"><strong>Gross deferred tax liabilities:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets', window );">Amortization</a></td>
<td class="num">(258,618)<span></span>
</td>
<td class="num">(380,594)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals', window );">Accrual to cash adjustment</a></td>
<td class="num">(31,290)<span></span>
</td>
<td class="num">(53,771)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxLiabilitiesOther', window );">Other</a></td>
<td class="num">(4,150)<span></span>
</td>
<td class="num">(1,023)<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredIncomeTaxLiabilities', window );">Total deferred tax liabilities</a></td>
<td class="num">(294,058)<span></span>
</td>
<td class="num">(435,388)<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxLiabilities', window );">Net deferred tax liability</a></td>
<td class="num">$ (132,964)<span></span>
</td>
<td class="num">$ (207,552)<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredIncomeTaxLiabilities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of deferred tax liability attributable to taxable temporary differences.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-03(15)(b)(2))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879938&amp;loc=d3e572229-122910<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-03(15)(2))<br> -URI http://asc.fasb.org/extlink&amp;oid=6876686&amp;loc=d3e534808-122878<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(26)(a))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(26)(b))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32537-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredIncomeTaxLiabilities</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences and carryforwards.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32537-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsGross</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences and carryforwards.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (b),(c)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32537-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsNet</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsOperatingLossCarryforwards">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before allocation of valuation allowances of deferred tax asset attributable to deductible operating loss carryforwards.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 25<br> -Paragraph 20<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=96869850&amp;loc=d3e28680-109314<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32621-109319<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32632-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsOperatingLossCarryforwards</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsOther">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount, before allocation of valuation allowance, of deferred tax asset attributable to deductible temporary differences, classified as other.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32621-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32632-109319<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 25<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=96869850&amp;loc=d3e28680-109314<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsOther</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences from property, plant, and equipment.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences from share-based compensation.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32632-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 25<br> -Paragraph 20<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=96869850&amp;loc=d3e28680-109314<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32621-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences from the allowance for doubtful accounts.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 25<br> -Paragraph 20<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=96869850&amp;loc=d3e28680-109314<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32632-109319<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32621-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount, before allocation of valuation allowance, of deferred tax asset attributable to deductible temporary differences from reserves, classified as other.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32632-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 25<br> -Paragraph 20<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=96869850&amp;loc=d3e28680-109314<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32621-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsValuationAllowance">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of deferred tax assets for which it is more likely than not that a tax benefit will not be realized.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32537-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsValuationAllowance</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxLiabilities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount, after deferred tax asset, of deferred tax liability attributable to taxable differences without jurisdictional netting.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 45<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84176650&amp;loc=d3e31931-109318<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32537-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxLiabilities</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxLiabilitiesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxLiabilitiesAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of deferred tax liability attributable to taxable temporary differences from reserves and accruals.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
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<td><strong> Period Type:</strong></td>
<td>instant</td>
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</div></td></tr>
</table>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of deferred tax liability attributable to taxable temporary differences from intangible assets other than goodwill.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32632-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 25<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=96869850&amp;loc=d3e28680-109314<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32621-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets</td>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of deferred tax liability attributable to taxable temporary differences classified as other.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32632-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 25<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=96869850&amp;loc=d3e28680-109314<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32621-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxLiabilitiesOther</td>
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<td>us-gaap_</td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxDisclosureAbstract</td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6916797392">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Income Taxes - Schedule of Activity Related to Gross Unrecognized Tax Benefits (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxDisclosureAbstract', window );"><strong>Income Tax Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
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<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefits', window );">Balance at beginning of year</a></td>
<td class="nump">$ 9,469<span></span>
</td>
<td class="nump">$ 18,447<span></span>
</td>
<td class="nump">$ 17,165<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions', window );">Increases related to prior year tax positions</a></td>
<td class="nump">2,284<span></span>
</td>
<td class="nump">301<span></span>
</td>
<td class="nump">467<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions', window );">Decreases related to prior year tax positions</a></td>
<td class="num">(143)<span></span>
</td>
<td class="num">(3,927)<span></span>
</td>
<td class="num">(1,168)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions', window );">Increases related to current year tax positions</a></td>
<td class="nump">1,430<span></span>
</td>
<td class="nump">2,258<span></span>
</td>
<td class="nump">3,675<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities', window );">Settlements</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(5,644)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations', window );">Decreases related to lapse of statutes of limitation</a></td>
<td class="num">(2,068)<span></span>
</td>
<td class="num">(1,966)<span></span>
</td>
<td class="num">(1,692)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefits', window );">Balance at end of year</a></td>
<td class="nump">$ 10,972<span></span>
</td>
<td class="nump">$ 9,469<span></span>
</td>
<td class="nump">$ 18,447<span></span>
</td>
</tr>
</table>
<div style="display: none;">
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxDisclosureAbstract</td>
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<td><strong> Balance Type:</strong></td>
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<td><strong> Period Type:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of unrecognized tax benefits.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefits</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<td><strong> Balance Type:</strong></td>
<td>credit</td>
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<td><strong> Period Type:</strong></td>
<td>instant</td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of decrease in unrecognized tax benefits resulting from tax positions taken in prior period tax returns.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (a)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of decrease in unrecognized tax benefits resulting from settlements with taxing authorities.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (a)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Data Type:</strong></td>
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<td><strong> Balance Type:</strong></td>
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<td><strong> Period Type:</strong></td>
<td>duration</td>
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</table></div>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase in unrecognized tax benefits resulting from tax positions that have been or will be taken in current period tax return.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (a)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions</td>
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<td><strong> Data Type:</strong></td>
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<td><strong> Balance Type:</strong></td>
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<td><strong> Period Type:</strong></td>
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase in unrecognized tax benefits resulting from tax positions taken in prior period tax returns.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (a)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Data Type:</strong></td>
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</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
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<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
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</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of decrease in unrecognized tax benefits resulting from lapses of applicable statutes of limitations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (a)(4)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations</td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6935938112">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Common and Common Equivalent Shares - Schedule of Calculation of Shares Used in Basic and Diluted Net Income Per Share (Detail) - shares<br> shares in Thousands</strong></div></th>
<th class="th" colspan="8">3 Months Ended</th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Sep. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Sep. 30, 2016</div></th>
<th class="th"><div>Jun. 30, 2016</div></th>
<th class="th"><div>Mar. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerShareAbstract', window );"><strong>Earnings Per Share [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_WeightedAverageNumberOfSharesOutstandingBasic', window );">Weighted average number of common shares outstanding</a></td>
<td class="nump">92,756<span></span>
</td>
<td class="nump">92,589<span></span>
</td>
<td class="nump">92,181<span></span>
</td>
<td class="nump">92,360<span></span>
</td>
<td class="nump">92,728<span></span>
</td>
<td class="nump">92,604<span></span>
</td>
<td class="nump">92,182<span></span>
</td>
<td class="nump">92,269<span></span>
</td>
<td class="nump">92,431<span></span>
</td>
<td class="nump">92,422<span></span>
</td>
<td class="nump">93,077<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements', window );">Weighted average number of dilutive common share equivalents</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">527<span></span>
</td>
<td class="nump">687<span></span>
</td>
<td class="nump">883<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding', window );">Weighted average number of common and common equivalent shares outstanding</a></td>
<td class="nump">93,159<span></span>
</td>
<td class="nump">92,881<span></span>
</td>
<td class="nump">92,812<span></span>
</td>
<td class="nump">93,143<span></span>
</td>
<td class="nump">93,347<span></span>
</td>
<td class="nump">93,146<span></span>
</td>
<td class="nump">92,945<span></span>
</td>
<td class="nump">93,091<span></span>
</td>
<td class="nump">92,958<span></span>
</td>
<td class="nump">93,109<span></span>
</td>
<td class="nump">93,960<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount', window );">Antidilutive securities not included in the diluted net income per common share calculation</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">107<span></span>
</td>
<td class="nump">2<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Securities (including those issuable pursuant to contingent stock agreements) that could potentially dilute basic earnings per share (EPS) or earnings per unit (EPU) in the future that were not included in the computation of diluted EPS or EPU because to do so would increase EPS or EPU amounts or decrease loss per share or unit amounts for the period presented.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3550-109257<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EarningsPerShareAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EarningsPerShareAbstract</td>
</tr>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Additional shares included in the calculation of diluted EPS as a result of the potentially dilutive effect of share based payment arrangements using the treasury stock method.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3550-109257<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28A<br> -URI http://asc.fasb.org/extlink&amp;oid=96947427&amp;loc=d3e1500-109256<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The average number of shares or units issued and outstanding that are used in calculating diluted EPS or earnings per unit (EPU), determined based on the timing of issuance of shares or units in the period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 45<br> -Paragraph 16<br> -URI http://asc.fasb.org/extlink&amp;oid=96947427&amp;loc=d3e1505-109256<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3550-109257<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
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<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_WeightedAverageNumberOfSharesOutstandingBasic">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of [basic] shares or units, after adjustment for contingently issuable shares or units and other shares or units not deemed outstanding, determined by relating the portion of time within a reporting period that common shares or units have been outstanding to the total time in that period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3550-109257<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 45<br> -Paragraph 10<br> -URI http://asc.fasb.org/extlink&amp;oid=96947427&amp;loc=d3e1448-109256<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_WeightedAverageNumberOfSharesOutstandingBasic</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
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<DOCUMENT>
<TYPE>XML
<SEQUENCE>85
<FILENAME>R67.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
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<body>
<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6767393120">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Stock Incentive Plans and Stock Purchase Plans - Additional Information (Detail) - USD ($)<br></strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommonStockSharesAuthorized', window );">Common stock, aggregate shares authorized</a></td>
<td class="nump">200,000,000<span></span>
</td>
<td class="nump">200,000,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AllocatedShareBasedCompensationExpense', window );">Stock-based compensation expense related to its stock incentive plans, ESPP and SPP</a></td>
<td class="nump">$ 29,600,000<span></span>
</td>
<td class="nump">$ 34,000,000<span></span>
</td>
<td class="nump">$ 32,100,000<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue', window );">Aggregate fair value of restricted and deferred stocks vested</a></td>
<td class="nump">$ 29,300,000<span></span>
</td>
<td class="nump">$ 29,800,000<span></span>
</td>
<td class="nump">$ 31,600,000<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue', window );">Weighted average grant-date fair value of restricted and deferred stock awards granted</a></td>
<td class="nump">$ 54.22<span></span>
</td>
<td class="nump">$ 67.90<span></span>
</td>
<td class="nump">$ 70.44<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue', window );">Aggregate intrinsic value of stock options exercised</a></td>
<td class="nump">$ 5,500,000<span></span>
</td>
<td class="nump">$ 6,800,000<span></span>
</td>
<td class="nump">$ 11,300,000<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation', window );">Excess tax benefit related to employee stock incentive plans</a></td>
<td class="nump">0<span></span>
</td>
<td class="nump">4,131,000<span></span>
</td>
<td class="nump">11,583,000<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation', window );">Cash proceeds received from the exercise of stock options</a></td>
<td class="nump">$ 4,800,000<span></span>
</td>
<td class="nump">$ 4,700,000<span></span>
</td>
<td class="nump">$ 6,100,000<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AwardTypeAxis=us-gaap_EmployeeStockOptionMember', window );">Stock Option [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1', window );">Award vesting period</a></td>
<td class="text">3 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AwardTypeAxis=us-gaap_EmployeeStockOptionMember', window );">Stock Option [Member] | Maximum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod', window );">Vesting period of options, maximum years</a></td>
<td class="text">10 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AwardTypeAxis=us-gaap_RestrictedStockMember', window );">Restricted Stock [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1', window );">Award vesting period</a></td>
<td class="text">3 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AwardTypeAxis=md_RestrictedAndDeferredStockUnitsMember', window );">Restricted and Deferred Stock Units [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1', window );">Unrecognized compensation expense related to non-vested restricted stock, weighted-average period in years</a></td>
<td class="text">1 year 7 months 6 days<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions', window );">Unrecognized compensation expense related to non-vested restricted shares</a></td>
<td class="nump">$ 30,900,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PlanNameAxis=md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember', window );">1996 Non-Qualified Employee Stock Purchase Plan [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent', window );">Percentage of market value of common stock at which employees are permitted to purchase</a></td>
<td class="nump">85.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PlanNameAxis=md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember', window );">2015 Non-Qualified Stock Purchase Plan [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent', window );">Percentage of market value of common stock at which employees are permitted to purchase</a></td>
<td class="nump">90.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PlanNameAxis=md_AmendedAndRestatedTwoThousandEightPlanMember', window );">Amended and Restated 2008 Plan [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant', window );">Shares available for future grants and awards under Stock Incentive Plans</a></td>
<td class="nump">3,400,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PlanNameAxis=md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember', window );">1996 Non-Qualified Employee Stock Purchase Plan and 2015 Non-Qualified Stock Purchase Plan [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans', window );">Aggregate number Shares issued under Stock Purchase Plans</a></td>
<td class="nump">400,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommonStockSharesAuthorized', window );">Common stock, aggregate shares authorized</a></td>
<td class="nump">2,600,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommonStockCapitalSharesReservedForFutureIssuance', window );">Common stock, reserved for issuance</a></td>
<td class="nump">1,900,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase in additional paid in capital (APIC) resulting from a tax benefit associated with share-based compensation plan other than an employee stock ownership plan (ESOP). Includes, but is not limited to, excess tax benefit.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 740<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=79981250&amp;loc=d3e23524-113945<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.3-04)<br> -URI http://asc.fasb.org/extlink&amp;oid=27012166&amp;loc=d3e187085-122770<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84159872&amp;loc=d3e21463-112644<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AllocatedShareBasedCompensationExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Represents the expense recognized during the period arising from equity-based compensation arrangements (for example, shares of stock, unit, stock options or other equity instruments) with employees, directors and certain consultants qualifying for treatment as employees.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB Topic 14.F)<br> -URI http://asc.fasb.org/extlink&amp;oid=27013229&amp;loc=d3e301413-122809<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5047-113901<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (h)(1)(i)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AllocatedShareBasedCompensationExpense</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommonStockCapitalSharesReservedForFutureIssuance">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Aggregate number of common shares reserved for future issuance.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02.29)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CommonStockCapitalSharesReservedForFutureIssuance</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommonStockSharesAuthorized">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The maximum number of common shares permitted to be issued by an entity's charter and bylaws.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CommonStockSharesAuthorized</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Weighted average period over which unrecognized compensation is expected to be recognized for equity-based compensation plans, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (i)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Unrecognized cost of unvested share-based awards, other than options, awarded to employees as compensation.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (i)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate cash inflow comprised of the amount received from (a) employees to acquire the entity's shares under incentive awards, including stock option exercises and restricted stock arrangements, and (b) the excess tax benefit arising from such transactions.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Period which an employee's right to exercise an award is no longer contingent on satisfaction of either a service condition, market condition or a performance condition, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The weighted average fair value at grant date for nonvested equity-based awards issued during the period on other than stock (or unit) option plans (for example, phantom stock or unit plan, stock or unit appreciation rights plan, performance target plan).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(2)(iii)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Fair value of share-based awards for which the grantee gained the right by satisfying service and performance requirements, to receive or retain shares or units, other instruments, or cash.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (d)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The difference between the maximum number of shares (or other type of equity) authorized for issuance under the plan (including the effects of amendments and adjustments), and the sum of: 1) the number of shares (or other type of equity) already issued upon exercise of options or other equity-based awards under the plan; and 2) shares (or other type of equity) reserved for issuance on granting of outstanding awards, net of cancellations and forfeitures, if applicable.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of accumulated difference between fair value of underlying shares on dates of exercise and exercise price on options exercised (or share units converted) into shares.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (d)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Period from grant date that an equity-based award expires, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Purchase price of common stock expressed as a percentage of its fair value.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of shares issued during the period as a result of an employee stock purchase plan.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84159872&amp;loc=d3e21463-112644<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(28))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.3-04)<br> -URI http://asc.fasb.org/extlink&amp;oid=27012166&amp;loc=d3e187085-122770<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AwardTypeAxis=us-gaap_EmployeeStockOptionMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AwardTypeAxis=us-gaap_EmployeeStockOptionMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_RangeAxis=us-gaap_MaximumMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RangeAxis=us-gaap_MaximumMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AwardTypeAxis=us-gaap_RestrictedStockMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AwardTypeAxis=us-gaap_RestrictedStockMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AwardTypeAxis=md_RestrictedAndDeferredStockUnitsMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AwardTypeAxis=md_RestrictedAndDeferredStockUnitsMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
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<td><strong> Data Type:</strong></td>
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<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PlanNameAxis=md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember</td>
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<DESCRIPTION>IDEA: XBRL DOCUMENT
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<html>
<head>
<title></title>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6778457392">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Stock Incentive Plans and Stock Purchase Plans - Schedule of Restricted Stock and Deferred Stock Awards (Detail) - $ / shares<br></strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract', window );"><strong>Disclosure of Compensation Related Costs, Share-based Payments [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber', window );">Number of Shares, Non-vested shares at January 1, 2017</a></td>
<td class="nump">946,329<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
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</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod', window );">Number of Shares, Awarded</a></td>
<td class="nump">637,529<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod', window );">Number of Shares, Forfeited</a></td>
<td class="num">(91,730)<span></span>
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<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod', window );">Number of Shares, Vested</a></td>
<td class="num">(451,094)<span></span>
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<td class="text">&#160;<span></span>
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<td class="text">&#160;<span></span>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber', window );">Number of Shares, Non-vested shares at December 31, 2017</a></td>
<td class="nump">1,041,034<span></span>
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<td class="nump">946,329<span></span>
</td>
<td class="text">&#160;<span></span>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue', window );">Weighted Average Fair Value, Non-vested shares at January 1, 2017</a></td>
<td class="nump">$ 66.98<span></span>
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<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
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<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue', window );">Weighted Average Fair Value, Awarded</a></td>
<td class="nump">54.22<span></span>
</td>
<td class="nump">$ 67.90<span></span>
</td>
<td class="nump">$ 70.44<span></span>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue', window );">Weighted Average Fair Value, Forfeited</a></td>
<td class="nump">64.82<span></span>
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<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
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<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue', window );">Weighted Average Fair Value, Vested</a></td>
<td class="nump">65.00<span></span>
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<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue', window );">Weighted Average Fair Value, Non-vested shares at December 31, 2017</a></td>
<td class="nump">$ 60.21<span></span>
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<td class="nump">$ 66.98<span></span>
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<td class="text">&#160;<span></span>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The number of equity-based payment instruments, excluding stock (or unit) options, that were forfeited during the reporting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(1)(iv)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
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<td><strong> Period Type:</strong></td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Weighted average fair value as of the grant date of equity-based award plans other than stock (unit) option plans that were not exercised or put into effect as a result of the occurrence of a terminating event.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(2)(iii)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
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<td><strong> Period Type:</strong></td>
<td>duration</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The number of grants made during the period on other than stock (or unit) option plans (for example, phantom stock or unit plan, stock or unit appreciation rights plan, performance target plan).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(2)(iii)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
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<td><strong> Balance Type:</strong></td>
<td>na</td>
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<td>duration</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The weighted average fair value at grant date for nonvested equity-based awards issued during the period on other than stock (or unit) option plans (for example, phantom stock or unit plan, stock or unit appreciation rights plan, performance target plan).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(2)(iii)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue</td>
</tr>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The number of non-vested equity-based payment instruments, excluding stock (or unit) options, that validly exist and are outstanding as of the balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(2)(i)-(ii)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
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<td><strong> Period Type:</strong></td>
<td>instant</td>
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<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The weighted average fair value of nonvested awards on equity-based plans excluding option plans (for example, phantom stock or unit plan, stock or unit appreciation rights plan, revenue or profit achievement stock award plan) for which the employer is contingently obligated to issue equity instruments or transfer assets to an employee who has not yet satisfied service or performance criteria necessary to gain title to proceeds from the sale of the award or underlying shares or units.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(2)(i)-(ii)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The number of equity-based payment instruments, excluding stock (or unit) options, that vested during the reporting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(2)(iii)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The weighted average fair value as of grant date pertaining to an equity-based award plan other than a stock (or unit) option plan for which the grantee gained the right during the reporting period, by satisfying service and performance requirements, to receive or retain shares or units, other instruments, or cash in accordance with the terms of the arrangement.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(2)(iii)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
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<head>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6767030192">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Stock Incentive Plans and Stock Purchase Plans - Schedule of Activity and Certain Other Information Related to Stock Option Awards (Detail) - USD ($)<br> $ / shares in Units, $ in Millions</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract', window );"><strong>Disclosure of Compensation Related Costs, Share-based Payments [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber', window );">Number of Shares, Outstanding at January 1, 2017</a></td>
<td class="nump">410,286<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised', window );">Number of Shares, Exercised</a></td>
<td class="num">(163,944)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber', window );">Number of Shares, Outstanding at December 31, 2017</a></td>
<td class="nump">246,342<span></span>
</td>
<td class="nump">410,286<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber', window );">Number of Shares, Exercisable at December 31, 2017</a></td>
<td class="nump">246,342<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice', window );">Weighted Average Exercise Price, Outstanding at January 1, 2017</a></td>
<td class="nump">$ 28.33<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice', window );">Weighted Average Exercise Price, Exercised</a></td>
<td class="nump">29.57<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice', window );">Weighted Average Exercise Price, Outstanding at December 31, 2017</a></td>
<td class="nump">27.51<span></span>
</td>
<td class="nump">$ 28.33<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice', window );">Weighted Average Exercise Price, Exercisable at December 31, 2017</a></td>
<td class="nump">$ 27.51<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2', window );">Weighted Average Remaining Contractual Term (in years), Outstanding at December 31, 2017</a></td>
<td class="text">1 year 6 months<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1', window );">Weighted Average Remaining Contractual Term (in years), Exercisable at December 31, 2017</a></td>
<td class="text">1 year 6 months<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue', window );">Aggregate Intrinsic Value, Exercised</a></td>
<td class="nump">$ 5.5<span></span>
</td>
<td class="nump">$ 6.8<span></span>
</td>
<td class="nump">$ 11.3<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue', window );">Aggregate Intrinsic Value, Outstanding at December 31, 2017</a></td>
<td class="nump">6.4<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1', window );">Aggregate Intrinsic Value, Exercisable at December 31, 2017</a></td>
<td class="nump">$ 6.4<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The number of shares into which fully or partially vested stock options outstanding as of the balance sheet date can be currently converted under the option plan.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(1)(iii)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The weighted-average price as of the balance sheet date at which grantees can acquire the shares reserved for issuance on vested portions of options outstanding and currently exercisable under the stock option plan.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(1)(iii)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of accumulated difference between fair value of underlying shares on dates of exercise and exercise price on options exercised (or share units converted) into shares.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (d)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount by which the current fair value of the underlying stock exceeds the exercise price of options outstanding.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of options outstanding, including both vested and non-vested options.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(1)(i)-(ii)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
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<tr>
<td><strong> Period Type:</strong></td>
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</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Weighted average price at which grantees can acquire the shares reserved for issuance under the stock option plan.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(1)(i)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Weighted average price at which option holders acquired shares when converting their stock options into shares.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
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<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
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<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of difference between fair value of the underlying shares reserved for issuance and exercise price of vested portions of options outstanding and currently exercisable.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
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<td><strong> Balance Type:</strong></td>
<td>debit</td>
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<td><strong> Period Type:</strong></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Weighted average remaining contractual term for vested portions of options outstanding and currently exercisable or convertible, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<td><strong> Balance Type:</strong></td>
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<td><strong> Period Type:</strong></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Weighted average remaining contractual term for option awards outstanding, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (e)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2</td>
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<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td><strong> Data Type:</strong></td>
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<td><strong> Balance Type:</strong></td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of share options (or share units) exercised during the current period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84159872&amp;loc=d3e21463-112644<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(28))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.3-04)<br> -URI http://asc.fasb.org/extlink&amp;oid=27012166&amp;loc=d3e187085-122770<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)(1)(iv)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=96867065&amp;loc=d3e5070-113901<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised</td>
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<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
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<td>xbrli:sharesItemType</td>
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<td>na</td>
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<td>duration</td>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6763660704">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Common Stock Repurchase Programs - Additional Information (Detail) - USD ($)<br></strong></div></th>
<th class="th" colspan="1"></th>
<th class="th" colspan="1"></th>
<th class="th" colspan="2">1 Months Ended</th>
<th class="th" colspan="3">12 Months Ended</th>
<th class="th" colspan="1"></th>
<th class="th" colspan="1"></th>
<th class="th" colspan="1"></th>
</tr>
<tr>
<th class="th"><div>Mar. 16, 2015</div></th>
<th class="th"><div>Dec. 17, 2014</div></th>
<th class="th"><div>Oct. 31, 2015</div></th>
<th class="th"><div>Jul. 31, 2015</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
<th class="th"><div>Mar. 31, 2015</div></th>
<th class="th"><div>Dec. 31, 2014</div></th>
<th class="th"><div>Oct. 31, 2014</div></th>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_CommonStockLineItems', window );"><strong>Common Stock [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
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<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodValue', window );">Common stock repurchased</a></td>
<td class="text">&#160;<span></span>
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<td class="text">&#160;<span></span>
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<td class="text">&#160;<span></span>
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<td class="text">&#160;<span></span>
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<td class="nump">$ 70,192,000<span></span>
</td>
<td class="nump">$ 61,828,000<span></span>
</td>
<td class="nump">$ 235,051,000<span></span>
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<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
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<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchaseProgramAuthorizedAmount1', window );">Common stock authorized for repurchase</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 600,000,000<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StatementEquityComponentsAxis=us-gaap_CommonStockMember', window );">Common Stock [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_CommonStockLineItems', window );"><strong>Common Stock [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodShares', window );">Repurchased common stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1,038,000<span></span>
</td>
<td class="nump">946,000<span></span>
</td>
<td class="nump">3,365,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
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<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodValue', window );">Common stock repurchased</a></td>
<td class="text">&#160;<span></span>
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<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 10,000<span></span>
</td>
<td class="nump">$ 9,000<span></span>
</td>
<td class="nump">$ 34,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
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<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AwardTypeAxis=us-gaap_RestrictedStockMember', window );">Restricted Stock [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_CommonStockLineItems', window );"><strong>Common Stock [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation', window );">Number of shares withheld to satisfy minimum statutory tax withholding obligations</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">38,257<span></span>
</td>
<td class="nump">46,490<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation', window );">Amount withheld to satisfy minimum statutory tax withholding obligations</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 2,100,000<span></span>
</td>
<td class="nump">$ 3,200,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareRepurchaseProgramAxis=md_AcceleratedShareRepurchaseAgreementsMember', window );">Accelerated Share Repurchase (ASR) Agreements [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_CommonStockLineItems', window );"><strong>Common Stock [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodShares', window );">Repurchased common stock, shares</a></td>
<td class="nump">2,200,000<span></span>
</td>
<td class="nump">2,500,000<span></span>
</td>
<td class="nump">300,000<span></span>
</td>
<td class="nump">300,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodValue', window );">Common stock repurchased</a></td>
<td class="nump">$ 200,000,000<span></span>
</td>
<td class="nump">$ 200,000,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt', window );">Common stock purchase</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 200,000,000<span></span>
</td>
<td class="nump">$ 200,000,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_CommonStockLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Common Stock [Line Items]</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_CommonStockLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash receipt from (payment to) bank; or stock received from (issuance to) bank in the settlement of the accelerated share repurchase agreement.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 30<br> -Section 25<br> -Paragraph 5<br> -URI http://asc.fasb.org/extlink&amp;oid=6405686&amp;loc=d3e22802-112653<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of adjustment to stockholders' equity associated with an employee's income tax withholding obligation as part of a net-share settlement of a share-based award.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>For net-share settlement of share-based awards when the employer settles employees' income tax withholding obligations, this element represents the number of shares the employees use to repay the employer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockRepurchaseProgramAuthorizedAmount1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of stock repurchase plan authorized.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockRepurchaseProgramAuthorizedAmount1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockRepurchasedDuringPeriodShares">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of shares that have been repurchased during the period and have not been retired and are not held in treasury. Some state laws may govern the circumstances under which an entity may acquire its own stock and prescribe the accounting treatment therefore. This element is used when state law does not recognize treasury stock.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(28))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.3-04)<br> -URI http://asc.fasb.org/extlink&amp;oid=27012166&amp;loc=d3e187085-122770<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84159872&amp;loc=d3e21463-112644<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockRepurchasedDuringPeriodShares</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockRepurchasedDuringPeriodValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Equity impact of the value of stock that has been repurchased during the period and has not been retired and is not held in treasury. Some state laws may mandate the circumstances under which an entity may acquire its own stock and prescribe the accounting treatment therefore. This element is used when state law does not recognize treasury stock.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.3-04)<br> -URI http://asc.fasb.org/extlink&amp;oid=27012166&amp;loc=d3e187085-122770<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(29))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84159872&amp;loc=d3e21463-112644<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(28))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockRepurchasedDuringPeriodValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StatementEquityComponentsAxis=us-gaap_CommonStockMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StatementEquityComponentsAxis=us-gaap_CommonStockMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AwardTypeAxis=us-gaap_RestrictedStockMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AwardTypeAxis=us-gaap_RestrictedStockMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareRepurchaseProgramAxis=md_AcceleratedShareRepurchaseAgreementsMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareRepurchaseProgramAxis=md_AcceleratedShareRepurchaseAgreementsMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
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<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
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</head>
<body>
<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6922316656">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Retirement Plans - Additional Information (Detail) - USD ($)<br> $ in Millions</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CompensationAndRetirementDisclosureAbstract', window );"><strong>Retirement Benefits [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DefinedContributionPlanCostRecognized', window );">Expense of retirement plans related to the 401(k) Plans</a></td>
<td class="nump">$ 50.7<span></span>
</td>
<td class="nump">$ 45.2<span></span>
</td>
<td class="nump">$ 39.7<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CompensationAndRetirementDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CompensationAndRetirementDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DefinedContributionPlanCostRecognized">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cost for defined contribution plan.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 715<br> -SubTopic 70<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=49170846&amp;loc=d3e28014-114942<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DefinedContributionPlanCostRecognized</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
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<FILENAME>R72.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
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<body>
<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6918128928">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Commitments and Contingencies - Additional Information (Detail) - USD ($)<br> $ in Millions</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommitmentsAndContingenciesDisclosureAbstract', window );"><strong>Commitments and Contingencies Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LeaseAndRentalExpense', window );">Rent expense</a></td>
<td class="nump">$ 42.6<span></span>
</td>
<td class="nump">$ 38.0<span></span>
</td>
<td class="nump">$ 31.6<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommitmentsAndContingenciesDisclosureAbstract">
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<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CommitmentsAndContingenciesDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LeaseAndRentalExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of rent expense incurred for leased assets, including but not limited to, furniture and equipment, that is not directly or indirectly associated with the manufacture, sale or creation of a product or product line.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LeaseAndRentalExpense</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
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<DOCUMENT>
<TYPE>XML
<SEQUENCE>91
<FILENAME>R73.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
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</head>
<body>
<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6765870176">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Commitments and Contingencies - Schedule of Future Minimum Lease Payments under Non-Cancelable Operating Leases (Detail)<br> $ in Thousands</strong></div></th>
<th class="th">
<div>Dec. 31, 2017 </div>
<div>USD ($)</div>
</th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommitmentsAndContingenciesDisclosureAbstract', window );"><strong>Commitments and Contingencies Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent', window );">2018</a></td>
<td class="nump">$ 34,337<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears', window );">2019</a></td>
<td class="nump">24,178<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears', window );">2020</a></td>
<td class="nump">16,633<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears', window );">2021</a></td>
<td class="nump">12,065<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears', window );">2022</a></td>
<td class="nump">8,125<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter', window );">Thereafter</a></td>
<td class="nump">9,934<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDue', window );">Total</a></td>
<td class="nump">$ 105,272<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommitmentsAndContingenciesDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CommitmentsAndContingenciesDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of required minimum rental payments for leases having an initial or remaining non-cancelable letter-terms in excess of one year.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 10<br> -Section 55<br> -Paragraph 40<br> -Subparagraph (Note 3)<br> -URI http://asc.fasb.org/extlink&amp;oid=82846649&amp;loc=d3e38371-112697<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLeasesFutureMinimumPaymentsDue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of required minimum rental payments for operating leases having an initial or remaining non-cancelable lease term in excess of one year due in the next fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 10<br> -Section 55<br> -Paragraph 40<br> -Subparagraph (Note 3)<br> -URI http://asc.fasb.org/extlink&amp;oid=82846649&amp;loc=d3e38371-112697<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of required minimum rental payments for operating leases having an initial or remaining non-cancelable lease term in excess of one year due in the fifth fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 10<br> -Section 55<br> -Paragraph 40<br> -Subparagraph (Note 3)<br> -URI http://asc.fasb.org/extlink&amp;oid=82846649&amp;loc=d3e38371-112697<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of required minimum rental payments for operating leases having an initial or remaining non-cancelable lease term in excess of one year due in the fourth fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 10<br> -Section 55<br> -Paragraph 40<br> -Subparagraph (Note 3)<br> -URI http://asc.fasb.org/extlink&amp;oid=82846649&amp;loc=d3e38371-112697<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of required minimum rental payments for operating leases having an initial or remaining non-cancelable lease term in excess of one year due in the third fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 10<br> -Section 55<br> -Paragraph 40<br> -Subparagraph (Note 3)<br> -URI http://asc.fasb.org/extlink&amp;oid=82846649&amp;loc=d3e38371-112697<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of required minimum rental payments for operating leases having an initial or remaining non-cancelable lease term in excess of one year due in the second fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 10<br> -Section 55<br> -Paragraph 40<br> -Subparagraph (Note 3)<br> -URI http://asc.fasb.org/extlink&amp;oid=82846649&amp;loc=d3e38371-112697<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of required minimum rental payments for operating leases having an initial or remaining non-cancelable lease term in excess of one year due after the fifth fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 10<br> -Section 55<br> -Paragraph 40<br> -Subparagraph (Note 3)<br> -URI http://asc.fasb.org/extlink&amp;oid=82846649&amp;loc=d3e38371-112697<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6765497456">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Selected Quarterly Financial Information - Summary of Company's Selected Quarterly Financial Information (Detail) - USD ($)<br> $ / shares in Units, shares in Thousands, $ in Thousands</strong></div></th>
<th class="th" colspan="8">3 Months Ended</th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Sep. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Sep. 30, 2016</div></th>
<th class="th"><div>Jun. 30, 2016</div></th>
<th class="th"><div>Mar. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_QuarterlyFinancialInformationDisclosureAbstract', window );"><strong>Quarterly Financial Information Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HealthCareOrganizationRevenue', window );">Net revenue</a></td>
<td class="nump">$ 910,820<span></span>
</td>
<td class="nump">$ 868,951<span></span>
</td>
<td class="nump">$ 842,944<span></span>
</td>
<td class="nump">$ 835,597<span></span>
</td>
<td class="nump">$ 830,770<span></span>
</td>
<td class="nump">$ 828,006<span></span>
</td>
<td class="nump">$ 771,759<span></span>
</td>
<td class="nump">$ 752,624<span></span>
</td>
<td class="nump">$ 3,458,312<span></span>
</td>
<td class="nump">$ 3,183,159<span></span>
</td>
<td class="nump">$ 2,779,996<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_PracticeSalariesAndBenefits', window );">Practice salaries and benefits</a></td>
<td class="nump">617,455<span></span>
</td>
<td class="nump">586,476<span></span>
</td>
<td class="nump">561,418<span></span>
</td>
<td class="nump">572,385<span></span>
</td>
<td class="nump">532,952<span></span>
</td>
<td class="nump">521,832<span></span>
</td>
<td class="nump">484,625<span></span>
</td>
<td class="nump">491,811<span></span>
</td>
<td class="nump">2,337,734<span></span>
</td>
<td class="nump">2,031,220<span></span>
</td>
<td class="nump">1,753,505<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_PracticeSuppliesAndOtherOperatingExpenses', window );">Practice supplies and other operating expenses</a></td>
<td class="nump">32,353<span></span>
</td>
<td class="nump">29,497<span></span>
</td>
<td class="nump">30,872<span></span>
</td>
<td class="nump">27,796<span></span>
</td>
<td class="nump">32,737<span></span>
</td>
<td class="nump">31,641<span></span>
</td>
<td class="nump">26,992<span></span>
</td>
<td class="nump">27,046<span></span>
</td>
<td class="nump">120,518<span></span>
</td>
<td class="nump">118,416<span></span>
</td>
<td class="nump">98,480<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_GeneralAndAdministrativeExpense', window );">General and administrative expenses</a></td>
<td class="nump">108,895<span></span>
</td>
<td class="nump">101,430<span></span>
</td>
<td class="nump">103,015<span></span>
</td>
<td class="nump">103,765<span></span>
</td>
<td class="nump">97,049<span></span>
</td>
<td class="nump">93,457<span></span>
</td>
<td class="nump">92,116<span></span>
</td>
<td class="nump">89,950<span></span>
</td>
<td class="nump">417,105<span></span>
</td>
<td class="nump">372,572<span></span>
</td>
<td class="nump">305,915<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DepreciationDepletionAndAmortization', window );">Depreciation and amortization</a></td>
<td class="nump">26,414<span></span>
</td>
<td class="nump">25,116<span></span>
</td>
<td class="nump">25,735<span></span>
</td>
<td class="nump">25,614<span></span>
</td>
<td class="nump">25,254<span></span>
</td>
<td class="nump">24,185<span></span>
</td>
<td class="nump">20,241<span></span>
</td>
<td class="nump">19,584<span></span>
</td>
<td class="nump">102,879<span></span>
</td>
<td class="nump">89,264<span></span>
</td>
<td class="nump">64,228<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingExpenses', window );">Total operating expenses</a></td>
<td class="nump">785,117<span></span>
</td>
<td class="nump">742,519<span></span>
</td>
<td class="nump">721,040<span></span>
</td>
<td class="nump">729,560<span></span>
</td>
<td class="nump">687,992<span></span>
</td>
<td class="nump">671,115<span></span>
</td>
<td class="nump">623,974<span></span>
</td>
<td class="nump">628,391<span></span>
</td>
<td class="nump">2,978,236<span></span>
</td>
<td class="nump">2,611,472<span></span>
</td>
<td class="nump">2,222,128<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingIncomeLoss', window );">Income from operations</a></td>
<td class="nump">125,703<span></span>
</td>
<td class="nump">126,432<span></span>
</td>
<td class="nump">121,904<span></span>
</td>
<td class="nump">106,037<span></span>
</td>
<td class="nump">142,778<span></span>
</td>
<td class="nump">156,891<span></span>
</td>
<td class="nump">147,785<span></span>
</td>
<td class="nump">124,233<span></span>
</td>
<td class="nump">480,076<span></span>
</td>
<td class="nump">571,687<span></span>
</td>
<td class="nump">557,868<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InvestmentIncomeNet', window );">Investment and other income</a></td>
<td class="nump">2,777<span></span>
</td>
<td class="nump">235<span></span>
</td>
<td class="nump">365<span></span>
</td>
<td class="nump">576<span></span>
</td>
<td class="nump">770<span></span>
</td>
<td class="nump">221<span></span>
</td>
<td class="nump">410<span></span>
</td>
<td class="nump">618<span></span>
</td>
<td class="nump">3,953<span></span>
</td>
<td class="nump">2,019<span></span>
</td>
<td class="nump">1,844<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InterestExpense', window );">Interest expense</a></td>
<td class="num">(19,844)<span></span>
</td>
<td class="num">(18,428)<span></span>
</td>
<td class="num">(18,535)<span></span>
</td>
<td class="num">(17,752)<span></span>
</td>
<td class="num">(16,356)<span></span>
</td>
<td class="num">(17,215)<span></span>
</td>
<td class="num">(15,058)<span></span>
</td>
<td class="num">(14,463)<span></span>
</td>
<td class="num">(74,559)<span></span>
</td>
<td class="num">(63,092)<span></span>
</td>
<td class="num">(23,110)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeLossFromEquityMethodInvestments', window );">Equity (losses) in earnings of unconsolidated affiliate</a></td>
<td class="num">(294)<span></span>
</td>
<td class="num">(240)<span></span>
</td>
<td class="nump">689<span></span>
</td>
<td class="nump">797<span></span>
</td>
<td class="nump">806<span></span>
</td>
<td class="nump">796<span></span>
</td>
<td class="nump">789<span></span>
</td>
<td class="nump">794<span></span>
</td>
<td class="nump">952<span></span>
</td>
<td class="nump">3,185<span></span>
</td>
<td class="nump">3,127<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NonoperatingIncomeExpense', window );">Total non-operating expenses</a></td>
<td class="num">(17,361)<span></span>
</td>
<td class="num">(18,433)<span></span>
</td>
<td class="num">(17,481)<span></span>
</td>
<td class="num">(16,379)<span></span>
</td>
<td class="num">(14,780)<span></span>
</td>
<td class="num">(16,198)<span></span>
</td>
<td class="num">(13,859)<span></span>
</td>
<td class="num">(13,051)<span></span>
</td>
<td class="num">(69,654)<span></span>
</td>
<td class="num">(57,888)<span></span>
</td>
<td class="num">(18,139)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest', window );">Income before income taxes</a></td>
<td class="nump">108,342<span></span>
</td>
<td class="nump">107,999<span></span>
</td>
<td class="nump">104,423<span></span>
</td>
<td class="nump">89,658<span></span>
</td>
<td class="nump">127,998<span></span>
</td>
<td class="nump">140,693<span></span>
</td>
<td class="nump">133,926<span></span>
</td>
<td class="nump">111,182<span></span>
</td>
<td class="nump">410,422<span></span>
</td>
<td class="nump">513,799<span></span>
</td>
<td class="nump">539,729<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxExpenseBenefit', window );">Income tax (provision) benefit</a></td>
<td class="nump">27,761<span></span>
</td>
<td class="num">(42,119)<span></span>
</td>
<td class="num">(40,725)<span></span>
</td>
<td class="num">(34,967)<span></span>
</td>
<td class="num">(49,919)<span></span>
</td>
<td class="num">(44,272)<span></span>
</td>
<td class="num">(51,601)<span></span>
</td>
<td class="num">(43,411)<span></span>
</td>
<td class="num">(90,050)<span></span>
</td>
<td class="num">(189,203)<span></span>
</td>
<td class="num">(204,038)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProfitLoss', window );">Net income</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">78,079<span></span>
</td>
<td class="nump">96,421<span></span>
</td>
<td class="nump">82,325<span></span>
</td>
<td class="nump">67,771<span></span>
</td>
<td class="nump">320,372<span></span>
</td>
<td class="nump">324,596<span></span>
</td>
<td class="nump">335,691<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NetIncomeLossAttributableToNoncontrollingInterest', window );">Net loss attributable to noncontrolling interests</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">88<span></span>
</td>
<td class="nump">102<span></span>
</td>
<td class="nump">128<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">318<span></span>
</td>
<td class="nump">629<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NetIncomeLoss', window );">Net income attributable to MEDNAX, Inc.</a></td>
<td class="nump">$ 136,103<span></span>
</td>
<td class="nump">$ 65,880<span></span>
</td>
<td class="nump">$ 63,698<span></span>
</td>
<td class="nump">$ 54,691<span></span>
</td>
<td class="nump">$ 78,079<span></span>
</td>
<td class="nump">$ 96,509<span></span>
</td>
<td class="nump">$ 82,427<span></span>
</td>
<td class="nump">$ 67,899<span></span>
</td>
<td class="nump">$ 320,372<span></span>
</td>
<td class="nump">$ 324,914<span></span>
</td>
<td class="nump">$ 336,320<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerShareBasic', window );">Earnings per share, Basic</a></td>
<td class="nump">$ 1.47<span></span>
</td>
<td class="nump">$ 0.71<span></span>
</td>
<td class="nump">$ 0.69<span></span>
</td>
<td class="nump">$ 0.59<span></span>
</td>
<td class="nump">$ 0.84<span></span>
</td>
<td class="nump">$ 1.04<span></span>
</td>
<td class="nump">$ 0.89<span></span>
</td>
<td class="nump">$ 0.74<span></span>
</td>
<td class="nump">$ 3.47<span></span>
</td>
<td class="nump">$ 3.52<span></span>
</td>
<td class="nump">$ 3.61<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerShareDiluted', window );">Earnings per share, Diluted</a></td>
<td class="nump">$ 1.46<span></span>
</td>
<td class="nump">$ 0.71<span></span>
</td>
<td class="nump">$ 0.69<span></span>
</td>
<td class="nump">$ 0.59<span></span>
</td>
<td class="nump">$ 0.84<span></span>
</td>
<td class="nump">$ 1.04<span></span>
</td>
<td class="nump">$ 0.89<span></span>
</td>
<td class="nump">$ 0.73<span></span>
</td>
<td class="nump">$ 3.45<span></span>
</td>
<td class="nump">$ 3.49<span></span>
</td>
<td class="nump">$ 3.58<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_WeightedAverageNumberOfSharesOutstandingBasic', window );">Weighted average shares, Basic</a></td>
<td class="nump">92,756<span></span>
</td>
<td class="nump">92,589<span></span>
</td>
<td class="nump">92,181<span></span>
</td>
<td class="nump">92,360<span></span>
</td>
<td class="nump">92,728<span></span>
</td>
<td class="nump">92,604<span></span>
</td>
<td class="nump">92,182<span></span>
</td>
<td class="nump">92,269<span></span>
</td>
<td class="nump">92,431<span></span>
</td>
<td class="nump">92,422<span></span>
</td>
<td class="nump">93,077<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding', window );">Weighted average shares, Diluted</a></td>
<td class="nump">93,159<span></span>
</td>
<td class="nump">92,881<span></span>
</td>
<td class="nump">92,812<span></span>
</td>
<td class="nump">93,143<span></span>
</td>
<td class="nump">93,347<span></span>
</td>
<td class="nump">93,146<span></span>
</td>
<td class="nump">92,945<span></span>
</td>
<td class="nump">93,091<span></span>
</td>
<td class="nump">92,958<span></span>
</td>
<td class="nump">93,109<span></span>
</td>
<td class="nump">93,960<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_PracticeSalariesAndBenefits">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Practice salaries and benefits.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_PracticeSalariesAndBenefits</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_PracticeSuppliesAndOtherOperatingExpenses">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate amount of supplies and other operating expenses directly attributable to the physician practices.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_PracticeSuppliesAndOtherOperatingExpenses</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DepreciationDepletionAndAmortization">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate expense recognized in the current period that allocates the cost of tangible assets, intangible assets, or depleting assets to periods that benefit from use of the assets.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DepreciationDepletionAndAmortization</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EarningsPerShareBasic">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3550-109257<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 55<br> -Paragraph 52<br> -URI http://asc.fasb.org/extlink&amp;oid=96948231&amp;loc=d3e4984-109258<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-04(19))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879464&amp;loc=d3e573970-122913<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=96947427&amp;loc=d3e1252-109256<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03(21))<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br><br>Reference 6: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04(23))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879574&amp;loc=d3e536633-122882<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EarningsPerShareBasic</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EarningsPerShareDiluted">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-04(19))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879464&amp;loc=d3e573970-122913<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=96947427&amp;loc=d3e1252-109256<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03(21))<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04(23))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879574&amp;loc=d3e536633-122882<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EarningsPerShareDiluted</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_GeneralAndAdministrativeExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate total of expenses of managing and administering the affairs of an entity, including affiliates of the reporting entity, which are not directly or indirectly associated with the manufacture, sale or creation of a product or product line.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03.4)<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_GeneralAndAdministrativeExpense</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_HealthCareOrganizationRevenue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of revenues recognized by the entity from providing services to in-patients, outpatients, residents in facilities owned or operated by the entity, from insurance premiums, or from goods provided or services performed.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03.1)<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_HealthCareOrganizationRevenue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of income (loss) from continuing operations, including income (loss) from equity method investments, before deduction of income tax expense (benefit), and income (loss) attributable to noncontrolling interest.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 940<br> -SubTopic 20<br> -Section 25<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=68072869&amp;loc=d3e41242-110953<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03(10))<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04(15))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879574&amp;loc=d3e536633-122882<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-04(8))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879464&amp;loc=d3e573970-122913<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeLossFromEquityMethodInvestments">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>This item represents the entity's proportionate share for the period of the net income (loss) of its investee (such as unconsolidated subsidiaries and joint ventures) to which the equity method of accounting is applied. This item includes income or expense related to stock-based compensation based on the investor's grant of stock to employees of an equity method investee.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03(12))<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-04(10))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879464&amp;loc=d3e573970-122913<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 323<br> -SubTopic 10<br> -Section 45<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=66022249&amp;loc=d3e33749-111570<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04(13)(f))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879574&amp;loc=d3e536633-122882<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeLossFromEquityMethodInvestments</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxExpenseBenefit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (a),(b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.4-08.(h))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxExpenseBenefit</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_InterestExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of the cost of borrowed funds accounted for as interest expense.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 835<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6450988&amp;loc=d3e26243-108391<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 835<br> -SubTopic 30<br> -Section 45<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=64930785&amp;loc=d3e28555-108399<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04.9)<br> -URI http://asc.fasb.org/extlink&amp;oid=6879574&amp;loc=d3e536633-122882<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_InterestExpense</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_InvestmentIncomeNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after accretion (amortization) of discount (premium), and investment expense, of interest income and dividend income on nonoperating securities.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03.8)<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03.7(a),(b))<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03.9)<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_InvestmentIncomeNet</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NetIncomeLoss">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 28<br> -URI http://asc.fasb.org/extlink&amp;oid=98514028&amp;loc=d3e3602-108585<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3550-109257<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04(22))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879574&amp;loc=d3e536633-122882<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 225<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-04(18))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879464&amp;loc=d3e573970-122913<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03(20))<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NetIncomeLoss</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NetIncomeLossAttributableToNoncontrollingInterest">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of Net Income (Loss) attributable to noncontrolling interest.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 55<br> -Paragraph 4J<br> -URI http://asc.fasb.org/extlink&amp;oid=84234705&amp;loc=SL4591551-111686<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1A<br> -Subparagraph (a)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161450&amp;loc=SL4573702-111684<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NetIncomeLossAttributableToNoncontrollingInterest</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NonoperatingIncomeExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate amount of income or expense from ancillary business-related activities (that is to say, excluding major activities considered part of the normal operations of the business).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 225<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.5-03.7)<br> -URI http://asc.fasb.org/extlink&amp;oid=63488584&amp;loc=d3e20235-122688<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NonoperatingIncomeExpense</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingExpenses">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Generally recurring costs associated with normal operations except for the portion of these expenses which can be clearly related to production and included in cost of sales or services. Includes selling, general and administrative expense.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingExpenses</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingIncomeLoss">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The net result for the period of deducting operating expenses from operating revenues.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingIncomeLoss</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProfitLoss">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 55<br> -Paragraph 4K<br> -URI http://asc.fasb.org/extlink&amp;oid=84234705&amp;loc=SL4591552-111686<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 45<br> -Paragraph 19<br> -URI http://asc.fasb.org/extlink&amp;oid=96868048&amp;loc=SL4569616-111683<br><br>Reference 3: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1A<br> -Subparagraph (c)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161450&amp;loc=SL4573702-111684<br><br>Reference 4: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 55<br> -Paragraph 4J<br> -URI http://asc.fasb.org/extlink&amp;oid=84234705&amp;loc=SL4591551-111686<br><br>Reference 5: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1A<br> -Subparagraph (a)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=84161450&amp;loc=SL4573702-111684<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProfitLoss</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_QuarterlyFinancialInformationDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The average number of shares or units issued and outstanding that are used in calculating diluted EPS or earnings per unit (EPU), determined based on the timing of issuance of shares or units in the period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 45<br> -Paragraph 16<br> -URI http://asc.fasb.org/extlink&amp;oid=96947427&amp;loc=d3e1505-109256<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3550-109257<br></p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of [basic] shares or units, after adjustment for contingently issuable shares or units and other shares or units not deemed outstanding, determined by relating the portion of time within a reporting period that common shares or units have been outstanding to the total time in that period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3550-109257<br><br>Reference 2: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 45<br> -Paragraph 10<br> -URI http://asc.fasb.org/extlink&amp;oid=96947427&amp;loc=d3e1448-109256<br></p></div>
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<span style="display: none;">v3.8.0.1</span><table class="report" border="0" cellspacing="2" id="idp6767463264">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Schedule II - Valuation and Qualifying Accounts (Detail) - USD ($)<br></strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ValuationAndQualifyingAccountsAbstract', window );"><strong>Valuation and Qualifying Accounts [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ValuationAllowancesAndReservesBalance', window );">Balance at beginning of year</a></td>
<td class="nump">$ 1,224,366<span></span>
</td>
<td class="nump">$ 1,129,301<span></span>
</td>
<td class="nump">$ 848,767<span></span>
</td>
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<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ValuationAllowancesAndReservesChargedToCostAndExpense', window );">Amount charged against operating revenue</a></td>
<td class="nump">8,285,317<span></span>
</td>
<td class="nump">7,464,030<span></span>
</td>
<td class="nump">6,389,195<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ValuationAllowancesAndReservesAdjustments', window );">Accounts receivable contractual adjustments and write-offs (net of recoveries)</a></td>
<td class="num">(8,223,648)<span></span>
</td>
<td class="num">(7,368,965)<span></span>
</td>
<td class="num">(6,108,661)<span></span>
</td>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ValuationAllowancesAndReservesBalance', window );">Balance at end of year</a></td>
<td class="nump">$ 1,286,035<span></span>
</td>
<td class="nump">$ 1,224,366<span></span>
</td>
<td class="nump">$ 1,129,301<span></span>
</td>
</tr>
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<div style="display: none;">
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase (decrease) in the allowances and reserves, which consist of the valuation and qualifying accounts that are either netted against the cost of an asset or that reflect a liability established to represent expected future costs, from adjustments.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 4<br> -Subparagraph (SX 210.12-09)<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e24092-122690<br></p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Total of allowances and reserves, the valuation and qualifying accounts that are either netted against the cost of an asset (in order to value it at its carrying value) or that reflect a liability established to represent expected future costs.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 4<br> -Subparagraph (SX 210.12-09)<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e24092-122690<br></p></div>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase in the allowances and reserves, which consist of the valuation and qualifying accounts that are either netted against the cost of an asset or that reflect a liability established to represent expected future costs, from charges to costs and expenses.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 4<br> -Subparagraph (SX 210.12-09)<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e24092-122690<br></p></div>
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end
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
